Treatment of severe diabetic acidosis with tris-hydroxymethyl aminomethane in a thirteen-year-old child |
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Authors: | Marano M Iodice F Stoppa F Tomasello C Perrotta D Cecchetti C Di Nardo M Ciampalini P Pirozzi N |
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Institution: | DEA-Area Rossa, Bambino Gesù' Pediatric Hospital , IRCCS, Rome, Italy. marcomarano@yahoo.it |
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Abstract: | Diabetic ketoacidosis is a severe complication of type I diabetes. A 13-year-old female (40 kg) patient was admitted to our Intensive Care Unit with severe metabolic acidosis (pH: 6.8), hyperglycemia (835 mg/dL) and coma. Her hemodynamic conditions were unstable and, even though a large amount of plasma expanders, crystalloids, and inotropic support were supplied, the patient went into cardiac arrest in the first hour of treatment. After resuscitation, a better hemodynamic balance was achieved and metabolic acidosis was treated with fluid replacement therapy, continuous insulin infusion, and Tris-hydroxymethyl aminomethane (THAM) as a buffering agent. This therapy rapidly improved her metabolic conditions. The patient was discharged 5 days after Intensive Care Unit admission in good condition and without neurological sequelae. |
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