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342510

Crystalloid Fluid Choice in Management of Pediatric Hyperglycemic Emergencies: Systematic Review and Meta-Analysis

Article

Last updated: 24 Dec 2024

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Tags

Clinical Research (Medical)

Abstract

Background: Diabetic ketoacidosis in children and hyperglycemic hyperosmolar state are hyperglycemic emergencies that continue to account for increased burden of hospitalizations. Methods: A systematic review included 426 patients to determine whether there are differences in biochemistries, clinical outcomes, and endocrine outcomes in patients who are administered 0.9% saline as compared to buffered and non- buffered crystalloid fluids in the treatment of hyperglycemic emergencies. Results: Four studies had evaluated serum bicarbonate level after normal saline and other fluid types of use. We found no statistically significant difference between the 2 treatment groups (WMD, -0.04; 95% CI, -0.44-0.36). No statistically significant difference between the 2 treatment groups (WMD, 0.01; 95% CI, 0.00-0.02). We found no significant difference between the 2 groups for anion gap (WMD, 5.74; 95% CI, 4.67 to 6.81). Our results showed significant heterogeneity across the studies (I2 = 93%, P <.0001). Regarding serum chloride level after other fluid types and normal saline use. Our analysis found statistically significant difference between the 2 treatment groups (WMD, 3.371; 95% CI, 3.26-3.4). We evaluated serum sodium levels after using normal saline compared to other fluid usage. No statistically significant difference between two groups was noted (WMD, -0.1; 95% CI, -2.73- 2.53). Conclusion: For the treatment of hyperglycemic situations, normal saline performed statistically indistinguishable from other non-buffered and buffered crystalloid fluids in terms of bicarbonate level, pH, and anion gap. However, normal saline demonstrated significantly greater serum chloride levels in the therapy of hyperglycemic situations when compared to alternative fluids.
 

DOI

10.21608/scumj.2024.342510

Keywords

Crystalloid Fluid, Pediatric Hyperglycemic Emergencies

Authors

First Name

Ahmed

Last Name

Mohammed

MiddleName

-

Affiliation

Department of Pediatrics and Neonatology, Al-Qantara Gharb General Hospital, Egypt.

Email

ahmed.awaad867@gmail.com

City

ismailia

Orcid

-

First Name

Mona K.

Last Name

Amin

MiddleName

-

Affiliation

Department of Pediatrics, Faculty of Medicine, Suez Canal University, Egypt.

Email

-

City

-

Orcid

-

First Name

Amina M.

Last Name

Abdelwahab

MiddleName

-

Affiliation

Department of Pediatrics, Faculty of Medicine, Suez Canal University, Egypt.

Email

-

City

-

Orcid

-

Volume

27

Article Issue

1

Related Issue

45916

Issue Date

2024-01-01

Receive Date

2024-02-22

Publish Date

2024-01-01

Page Start

21

Page End

30

Print ISSN

1110-6999

Online ISSN

2090-2581

Article File

SCUMJ_Volume 27_Issue 1_Pages 21-30.pdf

PDF . 322.2kB

Link

https://scumj.journals.ekb.eg/article_342510.html

Detail API

https://scumj.journals.ekb.eg/service?article_code=342510

Order

3

Type

Review Article

Type Code

2,902

Publication Type

Journal

Publication Title

Suez Canal University Medical Journal

Publication Link

https://scumj.journals.ekb.eg/

MainTitle

Crystalloid Fluid Choice in Management of Pediatric Hyperglycemic Emergencies: Systematic Review and Meta-Analysis

Details

Type

Article

Created At

24 Dec 2024