Optimal infusion therapy in children with diabetic ketoacidosis (DKA) is still unclear. There is insufficient evidence to support any crystalloid solution in children. Objective. To evaluate the efficacy of 1.5% solution of meglumine sodium succinate (MSS) in children with moderate-to-severe DKA. Material and methods. An observational study included patients aged 7—17 years with moderate-to-severe DKA. All patients (n=60) received standard infusion therapy after admission to intensive care unit (ICU). Participants in the main group (n=30) additionally received 1.5% MSS at a dose of 10 ml/kg/day. Primary endpoints were time to DKA regression and proportion of patients with compensation after 24 and 48 hours. Logistic and linear regression methods were used. Results. DKA regressed in 90% of patients in the MSS group and 60% in the control group within 24 hours (p<0.001). After 48 hours, DKA regressed in all patients of both groups. In the main group, time to DKA regression was 16.5 hours, ICU-stay — 20.0 hours, time to recovery of consciousness — 4.0 hours. In the control group, these values were 24.0, 29.2 and 8.0 hours, respectively (p<0.001). Conclusion. We observed superiority of MSS for infusion therapy in school-age children with moderate-to-severe DKA. Faster normalization of clinical and laboratory parameters in the MSS group reduced ICU-stay.
Kozlov et al. (Wed,) studied this question.