Mohammed, A., Amin, M., Abdelwahab, A. (2024). Crystalloid Fluid Choice in Management of Pediatric Hyperglycemic Emergencies: Systematic Review and Meta-Analysis. Suez Canal University Medical Journal, 27(1), 21-30. doi: 10.21608/scumj.2024.342510
Ahmed Mohammed; Mona K. Amin; Amina M. Abdelwahab. "Crystalloid Fluid Choice in Management of Pediatric Hyperglycemic Emergencies: Systematic Review and Meta-Analysis". Suez Canal University Medical Journal, 27, 1, 2024, 21-30. doi: 10.21608/scumj.2024.342510
Mohammed, A., Amin, M., Abdelwahab, A. (2024). 'Crystalloid Fluid Choice in Management of Pediatric Hyperglycemic Emergencies: Systematic Review and Meta-Analysis', Suez Canal University Medical Journal, 27(1), pp. 21-30. doi: 10.21608/scumj.2024.342510
Mohammed, A., Amin, M., Abdelwahab, A. Crystalloid Fluid Choice in Management of Pediatric Hyperglycemic Emergencies: Systematic Review and Meta-Analysis. Suez Canal University Medical Journal, 2024; 27(1): 21-30. doi: 10.21608/scumj.2024.342510
Crystalloid Fluid Choice in Management of Pediatric Hyperglycemic Emergencies: Systematic Review and Meta-Analysis
1Department of Pediatrics and Neonatology, Al-Qantara Gharb General Hospital, Egypt.
2Department of Pediatrics, Faculty of Medicine, Suez Canal University, Egypt.
Abstract
Background: Diabetic ketoacidosis in children and hyperglycemic hyperosmolar state are hyperglycemic emergencies that continue to account for increased burden of hospitalizations. Methods: A systematic review included 426 patients to determine whether there are differences in biochemistries, clinical outcomes, and endocrine outcomes in patients who are administered 0.9% saline as compared to buffered and non- buffered crystalloid fluids in the treatment of hyperglycemic emergencies. Results: Four studies had evaluated serum bicarbonate level after normal saline and other fluid types of use. We found no statistically significant difference between the 2 treatment groups (WMD, -0.04; 95% CI, -0.44-0.36). No statistically significant difference between the 2 treatment groups (WMD, 0.01; 95% CI, 0.00-0.02). We found no significant difference between the 2 groups for anion gap (WMD, 5.74; 95% CI, 4.67 to 6.81). Our results showed significant heterogeneity across the studies (I2 = 93%, P <.0001). Regarding serum chloride level after other fluid types and normal saline use. Our analysis found statistically significant difference between the 2 treatment groups (WMD, 3.371; 95% CI, 3.26-3.4). We evaluated serum sodium levels after using normal saline compared to other fluid usage. No statistically significant difference between two groups was noted (WMD, -0.1; 95% CI, -2.73- 2.53). Conclusion: For the treatment of hyperglycemic situations, normal saline performed statistically indistinguishable from other non-buffered and buffered crystalloid fluids in terms of bicarbonate level, pH, and anion gap. However, normal saline demonstrated significantly greater serum chloride levels in the therapy of hyperglycemic situations when compared to alternative fluids.
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