Brief Review of A Clinical Trial of Fluid Infusion Rates in Pediatric Diabetic Ketoacidosis— Kuppermann 2018

This is a brief audio review. In the article Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis published, 2018 by Kuppermann and Colleagues, The outcomes and key points are as noted: The rate of fluid administration did not significantly affect neurologic outcomes in children. The primary trial outcome of deteriorated neurologic status (per two consecutive Glasgow Coma Scale scores of <14 any hour within the first 24 hours of treatment). The relative risk between fast versus slow sodium chloride fluid administration was 0.76 (0.44-1.33), P=0.34. This was a Randomized controlled trial, multicenter (non-blinded, with assignment via a 2 by 2 factorial design) with 1255 patients who were patients, 1389 instances of diabetic ketoacidosis, 0 to 18 years old, with a diagnosis of diabetic ketoacidosis with blood glucose greater than 300 milligrams per deciliter, venous pH less than 7.25, serum bicarbonate level of less than 15 millimoles per liter.

Kuppermann N, Ghetti S, Schunk JE, Stoner MJ, Rewers A, McManemy JK, Myers SR, Nigrovic LE, Garro A, Brown KM, Quayle KS, Trainor JL, Tzimenatos L, Bennett JE, DePiero AD, Kwok MY, Perry CS 3rd, Olsen CS, Casper TC, Dean JM, Glaser NS; PECARN DKA FLUID Study Group. Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis. N Engl J Med. 2018 Jun 14;378(24):2275-2287. doi: 10.1056/NEJMoa1716816. PMID: 29897851; PMCID: PMC6051773.