Electrocardiogram and Echocardiography Changes in Children With Diabetic Ketoacidosis
试验速览
- 阶段
- 不适用
- 入组人数
- 60
- 主要终点
- Echocardiography parameters
研究概览
简要总结
Diabetic ketoacidosis (DKA) is an important complication of childhood diabetes mellitus and the most frequent diabetes-related cause of death in children.
Diabetic ketoacidosis (DKA) is caused by a decrease in effective circulating insulin associated with increases in counter regulatory hormones including glucagon, catecholamines, cortisol, and growth hormone. This leads to increased glucose production by the liver and kidney and impaired peripheral glucose utilisation with resultant hyperglycaemia, and hyperosmolality. Increased lipolysis, with ketone body (beta-hydroxybutyrate, acetoacetate) production causes ketonaemia and metabolic acidosis. Hyperglycaemia and acidosis result in osmotic diuresis, dehydration, and obligate loss of electrolytes.
详细描述
DKA can affect cardiovascular function through several mechanisms. The effect of acidosis on the heart depends upon the pH level. In mild acidosis, there is increased catecholamine release which is compensated by increased inotropy, chronotropy, cardiac output and peripheral vascular resistance. When acidosis is severe, i.e. pH is less than 7.2, the H+ ions have a direct cardiac depressant action.
Fluid and electrolyte imbalance is very common in DKA, Potassium deficit is one of the most important of electrolyte imbalances seen in DKA as it can lead to fatal arrhythmias. The most common and perhaps the earliest ECG finding in hypokalemia is a prominent U wave, usually evident in leads II and III. The most common cardiac arrhythmias are atrial premature contractions, atrial tachycardia with or without atrioventricular block, supraventricular and ventricular premature contractions.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Cross Sectional
入排标准
- 年龄范围
- 1 Month 至 18 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Pediatric patients aged : 1 month -18years with diabetic ketoacidosis
排除标准
- •Pediatric Patients who have associated cardiovascular disease. ( congenital or rheumatic).
- •Pediatric patients with hyperglycemic hyperosmolar state.
- •Pediatric patients with other causes of metabolic acidosis.
结局指标
主要结局
Echocardiography parameters
时间窗: baseline
Right and left ventricular dimension during diabetic ketoacidosis and after correction.
Electrocardiogram parameters
时间窗: baseline
QT interval and PR interval.
次要结局
- Electrocardiogram changes(baseline)
- Echocardiography findings(baseline)
研究者
Fatima Younis
Principal investigator
Assiut University