title: Coagulation assessment in children with diabetic ketoacidosis.
abstract: OBJECTIVE
  To assess potential hypercoagulability during diabetic ketoacidosis in children.
  
  
  METHODS
  A prospective, controlled pilot study.
  
  
  METHODS
  University-affiliated pediatric critical care unit and emergency department in a tertiary care children's hospital.
  
  
  METHODS
  Children (1-18 years) admitted with an episode of diabetic ketoacidosis and healthy children as controls. All patients with diabetic ketoacidosis managed according to a preestablished protocol.
  
  
  METHODS
  Thromboelastography was performed using citrated whole-blood samples drawn at the time of admission and upon biochemical and clinical resolution of diabetic ketoacidosis. Citrated whole-blood samples drawn from healthy nondiabetic children acted as control samples.
  
  
  RESULTS
  Fifteen patients (11.7 ± 4.1 years) in the diabetic ketoacidosis group and 20 patients (8.9 ± 4.5 years; p = 0.06) in the control group completed the study. Values for standard thromboelastography parameters (R and K time, α angle, maximum amplitude, coagulation index, and Ly30) in the diabetic ketoacidosis group, both on admission and resolution, were within the control range; thromboelastography profiles of diabetic ketoacidosis patients on admission were not significantly different from profiles obtained upon diabetic ketoacidosis resolution. The mean α-angle was significantly higher in known diabetic patients compared with newly diagnosed diabetics on admission; however, it still remained within the control normal range.
  
  
  CONCLUSIONS
  Thromboelastographic assay results do not reflect a hypercoagulable state in this group of children with diabetic ketoacidosis. Further investigation is required to examine the potential role of injured endothelium in the suspected hypercoagulability during diabetic ketoacidosis.
authors: Critical Care Unit, Department of Paediatrics, Children's Hospital, University of Western Ontario, London, Ontario, Canada.
authors: Thai Hoa
authors: TH
authors: Tran
authors: Ibrahim
authors: I
authors: Al-Harfi
authors: Christopher C
authors: CC
authors: Harle
authors: Walter H A
authors: WH
authors: Kahr
authors: Gavin C
authors: GC
authors: Morrison
authors: Alik
authors: A
authors: Kornecki
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D016883:Diabetic Ketoacidosis / Q000150:complications*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D013916:Thrombelastography; D019851:Thrombophilia / Q000175:diagnosis* / Q000209:etiology