Ecg & Echo Changes in Children With DKA

Pediatric Disorder Clinical Trial

Official title: Electrocardiogram and Echocardiography Changes in Children With Diabetic Ketoacidosis

Status Not yet recruiting

Clinical Trial Summary

Diabetic ketoacidosis (DKA) is an important complication of childhood diabetes mellitus and the most frequent diabetes-related cause of death in children.

Diabetic ketoacidosis (DKA) is caused by a decrease in effective circulating insulin associated with increases in counter regulatory hormones including glucagon, catecholamines, cortisol, and growth hormone. This leads to increased glucose production by the liver and kidney and impaired peripheral glucose utilisation with resultant hyperglycaemia, and hyperosmolality. Increased lipolysis, with ketone body (beta-hydroxybutyrate, acetoacetate) production causes ketonaemia and metabolic acidosis. Hyperglycaemia and acidosis result in osmotic diuresis, dehydration, and obligate loss of electrolytes.

Clinical Trial Description

DKA can affect cardiovascular function through several mechanisms. The effect of acidosis on the heart depends upon the pH level. In mild acidosis, there is increased catecholamine release which is compensated by increased inotropy, chronotropy, cardiac output and peripheral vascular resistance. When acidosis is severe, i.e. pH is less than 7.2, the H+ ions have a direct cardiac depressant action.

Fluid and electrolyte imbalance is very common in DKA, Potassium deficit is one of the most important of electrolyte imbalances seen in DKA as it can lead to fatal arrhythmias. The most common and perhaps the earliest ECG finding in hypokalemia is a prominent U wave, usually evident in leads II and III. The most common cardiac arrhythmias are atrial premature contractions, atrial tachycardia with or without atrioventricular block, supraventricular and ventricular premature contractions. ;

Related Conditions & MeSH terms

• Pediatric Disorder

• NCT number: NCT03454152
• Study type: Observational [Patient Registry]
• Source: Assiut University
• Contact: Hanaa Mohammad, prof
• Phone: 01064747613
• Email: hae50@hotmail.com
• Status: Not yet recruiting
• Phase: N/A
• Start date: March 2019
• Completion date: June 2020