title: Dehydration in children with diabetic ketoacidosis: a prospective study.
abstract: OBJECTIVE
  To investigate the association between the degree of patient dehydration on presentation with diabetic ketoacidosis (DKA) and clinical and laboratory parameters obtained on admission.
  
  
  METHODS
  Prospective descriptive study.
  
  
  METHODS
  A tertiary care children's hospital.
  
  
  METHODS
  Thirty-nine paediatric patients (1 month-16 years) presenting with 42 episodes of DKA.
  
  
  METHODS
  Clinical and biochemical variables were collected on admission. Dehydration was calculated by measuring acute changes in body weight during the period of illness. All patients were treated according to a previously established protocol.
  
  
  METHODS
  Magnitude of dehydration, defined as % loss of body weight (LBW), was determined by the difference in body weight obtained at presentation and at discharge. The relationship between the magnitude of dehydration and the clinical assessment and biochemical parameters was examined.
  
  
  RESULTS
  The median (25th-75th centiles) magnitude of dehydration at presentation was 5.7% (3.8-8.3%) (mean ± SD 6.8 ± 5%). Neither the initial clinical assessment nor the comprehensive biochemical profile at admission correlated with the magnitude of dehydration. Despite considerable variation in the degree of dehydration and biochemical disequilibrium, all patients recovered from DKA within 24 h with a standardised therapeutic approach. Furthermore, the rapidity of patient recovery did not correlate with the magnitude of dehydration on presentation or the amount of fluid administered (median (25th-75th centiles) 48.8 ml/kg (38.5-60.3)) in the first 12 h.
  
  
  CONCLUSIONS
  The magnitude of dehydration in DKA is not reflected by either clinical or biochemical parameters. These findings need confirmation in larger studies.
authors.affiliation: Paediatric Critical Care, University of Western Ontario, Children's Hospital, London Health Sciences Centre, London, Ontario, Canada.
authors.forename: Maria
authors.initials: M
authors.lastname: Sottosanti
authors.forename: Gavin C
authors.initials: GC
authors.lastname: Morrison
authors.forename: Ram N
authors.initials: RN
authors.lastname: Singh
authors.forename: Ajay P
authors.initials: AP
authors.lastname: Sharma
authors.forename: Douglas D
authors.initials: DD
authors.lastname: Fraser
authors.forename: Khalid
authors.initials: K
authors.lastname: Alawi
authors.forename: Jamie A
authors.initials: JA
authors.lastname: Seabrook
authors.forename: Alik
authors.initials: A
authors.lastname: Kornecki
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001835:Body Weight / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D003681:Dehydration / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D016883:Diabetic Ketoacidosis / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers