Diabetic Ketoacidosis Clinical Trial
Official title:
Fluid Therapy and Cerebral Injury in Pediatric Diabetic Ketoacidosis
The investigators will conduct a randomized controlled trial comparing four different
intravenous (IV) fluid treatment protocols for pediatric diabetic ketoacidosis (DKA). Two
rates of rehydration will be compared; a more rapid rate and a slower rate. Within each of
these two basic rehydration protocols, the investigators will vary the type of rehydration
fluid used (0.9% saline or 0.45% saline). The investigators will compare the different
treatments by conducting assessments of neurological injury, by measuring the frequency of
significant cerebral edema, and by measuring long-term neurocognitive function.
These studies will allow us to determine whether variations in IV fluid treatment protocols
affect acute neurological outcomes of DKA. Additionally, they will provide important data
regarding the impact of DKA and DKA treatment on long-term neurocognitive function in
children. In this way, the investigators hope to identify a more ideal fluid management
strategy for children with DKA.
Previous studies have suggested that DKA may cause blood flow to the brain to be reduced and
that brain injury might result from this reduction in blood flow and/or the effects of
re-establishment of normal blood flow during DKA treatment with insulin and iv fluids. The
investigators hypothesize that more rapidly re-establishing normal blood flow to the brain
during DKA, by giving fluids more rapidly and using fluids with a higher sodium (salt)
content, will help to minimize brain injury caused by DKA.
These data will be compared to observational data from children with type 1 diabetes without DKA. ;
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