Increased Use of Hyperosmolar Therapy for Suspected Clinically Apparent Brain Injury in Pediatric Patients with Diabetic Ketoacidosis during the Peak of the COVID-19 Pandemic
Authors' conclusion
In conclusion, administration of hyperosmolar therapy for suspected CABI was more common during the peak of the COVID-19 pandemic, possibly a result of delayed presentation
Study context
- Population
- Patients aged ≤18 years presenting with diabetic ketoacidosis (DKA), identified through two databases
- Exposure
- Pandemic peak vs prepandemic period
- Outcome
- Proportion of patients with DKA receiving hyperosmolar therapy for suspected clinically apparent brain injury (CABI)
Methodological detailsPredefined criteria used to diagnose suspected clinically apparent brain injury (CABI); data from electronic medical record review
- Predefined criteria used to diagnose suspected CABI; data from electronic medical record review
Main finding
As reported in the abstract
Hyperosmolar therapy for suspected CABI
- Significant only among patients with newly diagnosed diabetes
- Pandemic vs Prepandemic: P = 0.014
Observational data: associations, not effects.
Further findings
Suspected CABI (both periods) vs DKA without suspected CABI
- More severe acidosis, lower Glasgow Coma Scale scores and longer hospital admissions with suspected CABI (P< 0.001 for all)
Blood urea nitrogen during the pandemic, suspected CABI vs no suspected CABI
- Significantly higher with suspected CABI, suggesting more severe dehydration
Characteristics of suspected CABI, prepandemic vs pandemic
- Clinical, biochemical and sociodemographic characteristics indistinguishable
Original publication
Increased Use of Hyperosmolar Therapy for Suspected Clinically Apparent Brain Injury in Pediatric Patients with Diabetic Ketoacidosis during the Peak of the COVID-19 Pandemic. Pediatr Diabetes. Published 28 February 2023. doi:10.
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