Use of a two-bag fluid administration protocol in the treatment of paediatric diabetic ketoacidosis: A retrospective review.

IF 1.8 4区医学 Q2 PEDIATRICS

Paediatrics & child health Pub Date : 2024-10-19 eCollection Date: 2025-05-01 DOI:10.1093/pch/pxae061

Rebecca Druken, Venita Harris, Elizabeth Wong, Farah Abdulsatar, Andrea Ens, Emma Metivier, Michael Miller, Jagraj Brar

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引用次数: 0

Abstract

Objectives: The 'two-bag method' for the treatment of diabetic ketoacidosis (DKA) uses two intravenous fluid bags, only one of which contains 10% dextrose. The bags are run concurrently with rates adjusted according to a rate change table to allow the relative amount of dextrose administered to be adjusted over time, without the need for bag replacements. The Children's Hospital at London Health Sciences Centre (CHLHSC) two-bag protocol is a simplified version of that used by other centres. The objective of this study was to ensure implementation of the CHLHSC two-bag protocol continues to provide safe and effective treatment of paediatric DKA and decreases resource utilization.

Methods: This retrospective chart review compared treatment pre- and post-protocol implementation.

Results: A total of 22 admissions were included. No significant differences in efficacy or safety outcomes were found between the protocol groups. There was no statistically significant difference between the two and one-bag protocols in time to normalization of serum bicarbonate (13.80 ± 7.68 versus 15.01 ± 7.53 h, P = 0.714), blood glucose correction (8.75 ± 4.86 versus 11.85 ± 4.92 h, P = 0.152), and critical care unit length of stay (24.26 ± 9.94 versus 32.30 ± 13.36, P = 0.399). The nursing staff appeared to appropriately implement the rate change table, but the chart documentation was poor.

Conclusions: The CHLHSC simplified two-bag protocol provides a safe and effective alternative to the one-bag protocol for DKA correction in paediatric patients and may also result in decreased resource utilization.

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使用双袋液体给药方案治疗儿童糖尿病酮症酸中毒：回顾性回顾。

目的：采用“两袋法”治疗糖尿病酮症酸中毒（DKA），采用两袋静脉输液，其中一袋仅含10%葡萄糖。袋子同时运行，根据费率变化表调整费率，以允许管理的葡萄糖的相对量随时间调整，而不需要更换袋子。伦敦健康科学中心儿童医院（CHLHSC）的双袋方案是其他中心使用的简化版本。本研究的目的是确保CHLHSC双袋方案的实施继续提供安全有效的儿科DKA治疗并减少资源利用。方法：本回顾性图表回顾比较治疗前后方案实施。结果：共纳入22例患者。方案组之间的疗效或安全性结果未发现显著差异。两种方案与一袋方案在血清碳酸氢盐正常化时间（13.80±7.68 h vs 15.01±7.53 h, P = 0.714）、血糖矫正时间（8.75±4.86 h vs 11.85±4.92 h, P = 0.152）、重症监护病房住院时间（24.26±9.94 h vs 32.30±13.36,P = 0.399）方面差异均无统计学意义。护理人员似乎适当地执行了变化率表，但图表文件较差。结论：CHLHSC简化两袋方案为儿科患者DKA矫正提供了一种安全有效的替代方案，但也可能导致资源利用率降低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Paediatrics & child health 医学-小儿科

CiteScore

2.10

自引率

5.30%

发文量

208

审稿时长

>12 weeks

期刊介绍： Paediatrics & Child Health (PCH) is the official journal of the Canadian Paediatric Society, and the only peer-reviewed paediatric journal in Canada. Its mission is to advocate for the health and well-being of all Canadian children and youth and to educate child and youth health professionals across the country. PCH reaches 8,000 paediatricians, family physicians and other child and youth health professionals, as well as ministers and officials in various levels of government who are involved with child and youth health policy in Canada.