New research discovery could shorten ICU stays for children with diabetic ketoacidosis (Plasma beta-hydroxybutyrate (BOHB) <1.5 mmol/L)

Medical Xpress / Children's Hospital Boston / Pediatric Diabetes ^ | Feb. 17, 2023 | Albert McKeon / Elise Schlissel Tremblay et al

[ConservativeMind]

When a child with diabetic ketoacidosis (DKA) requires intensive care, clinicians often monitor blood ketone levels to determine whether treatment has successfully reversed the abnormal ketone production. Yet, the utility of blood ketone levels to diagnose DKA or determine whether a child's DKA has resolved have not been rigorously studied.

Elise Tremblay, MD shows that a particular value of plasma beta-hydroxybutyrate (BOHB) can signal that DKA has clinically resolved and intensive treatment can stop.

Widespread adoption of this defined endpoint could remove some of the uncertainty from monitoring DKA. It could potentially end intensive care at the right time—instead of having it extend unnecessarily—and free up ICU resources, Tremblay says.

Measurement of BOHB has become feasible thanks to technological advancements. It can be measured in a blood sample in a clinical chemistry laboratory, or through a fingerstick blood test with a handheld meter. In 2021, Tremblay and her colleagues found that BOHB can accurately predict DKA in children and adolescents who are in emergency room care. The finding set the stage for the latest round of research: arriving at an endpoint for DKA treatment.

For the current study, published in Pediatric Diabetes, Tremblay and her colleagues analyzed data from 403 hospitalized children who were treated for DKA with intravenous insulin and whose levels of BOHB were measured during that time.

Based on this information, the team determined a BOHB value of <1.5 mmol/L can be used to define resolution of DKA. Tremblay hopes the finding gives clinicians a better understanding of when intensive care of DKA can end. And with the use of handheld blood ketone meters to measure BOHB, which correlate well with laboratory measurements up to approximately 5 mmol/L, it could also provide some hospitals with a simpler, more accessible way to define resolution of DKA.

[ConservativeMind]

No need to keep kids in the ICU or hospital, if BOHB is under 1.5 mmol/L.

Get them home.

[ConservativeMind]

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[faucetman]

“New research discovery could shorten ICU stays for children with diabetic ketoacidosis (Plasma beta-hydroxybutyrate (BOHB) <1.5 mmol/L)”

While there, be sure to give them the “jab” and “booster”. /S

AVOID hospitals AT ALL COSTS!

They KILL people there!