title: Efficiency of fluid treatments with different sodium concentration in children with type 1 diabetic ketoacidosis.
abstract: OBJECTIVE
  The management of children with diabetic ketoacidosis (DKA) continues to be a controversial issue with regard to amount of intravenous fluid to be given, rate of delivery of fluid, and type of fluid to be used. We aimed to analyze the results obtained by administration of rehydration fluids of two different sodium (Na) concentrations (75 mEq/L vs. 100 mEq/L) in the treatment of children with DKA.
  
  
  METHODS
  Thirty-two children with DKA were assessed for efficacy and safety of fluid treatment. After an initial rehydration time, intravenous fluids were switched to a 5% dextrose solution with a Na content of 75 mEq/L (Group I, n=19) or 100 mEq/L (Group II, n=13). Venous blood samples were collected from all subjects at diagnosis and at the 4th, 8th, 16th and 24th hours of treatment.
  
  
  RESULTS
  Changes in blood glucose levels did not differ significantly between the two groups at the 4th, 8th, 16th and 24th hours of the follow-up. Nadir effective plasma osmolality (Peff osm) and Peff osm levels also did not show statistically significant differences. Plasma sodium (PNa) level did not drop lower than the level at diagnosis in both groups. The changes in PNa concentrations in the two groups were not statistically significant at diagnosis or in follow-up samples (p=0.74). pH, anion gap, pCO₂ and HCO₃ levels were also similar in Group I and Group II. The duration of a pH level of <7.3 was shorter in Group II, but this was not statistically significant (p=0.65). None of the patients enrolled in this study developed cerebral edema.
  
  
  CONCLUSIONS
  The efficacy and safety of rehydration fluids with Na concentrations of 75 or 100 mEq/L did not reveal any differences in children with DKA.
authors.affiliation: Ankara University School of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Ankara, Turkey. senaysavas@yahoo.com
authors.forename: Şenay
authors.initials: Ş
authors.lastname: Savaş-Erdeve
authors.forename: Merih
authors.initials: M
authors.lastname: Berberoğlu
authors.forename: Pembe
authors.initials: P
authors.lastname: Oygar
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Şıklar
authors.forename: Tanıl
authors.initials: T
authors.lastname: Kendirli
authors.forename: Bülent
authors.initials: B
authors.lastname: Hacıhamdioğlu
authors.forename: Pelin
authors.initials: P
authors.lastname: Bilir
authors.forename: Gönül
authors.initials: G
authors.lastname: Öçal
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012964:Sodium / Q000008:administration & dosage* / Q000097:blood; D018709:Statistics, Nonparametric
chemical_list: D001786:Blood Glucose; D012964:Sodium