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Purpose of Review <p>Pediatric diabetic ketoacidosis (DKA) poses significant risks, including severe neurological complications such as cerebral edema, which impacts mortality and long-term outcomes. Disparities in management between low-resource and high-resource settings highlight differences in treatment protocols and patient outcomes. This review aims to compare the management of pediatric DKA and associated neurological complications between low-resource and high-resource settings and to identify strategies to improve outcomes in diverse healthcare environments.</p> Recent Findings <p>A widespread search was conducted using databases PubMed, Scopus, Web of Science, and Google Scholar for studies from January 2010 to June 2024 with these keywords: diabetic ketoacidosis (DKA); pediatric; cerebral edema; neurologic complications; management protocols. Inclusion criteria focused on English-language studies on DKA management and neurological outcomes in pediatric populations. Both low-resource and high-resource settings were analyzed. Effective management of pediatric DKA requires early intervention and adherence to protocols. Disparities between settings necessitate further research on cost-effective solutions and implementation strategies to improve care globally.</p> Summary <p>High-resource settings benefit from advanced diagnostics, continuous insulin infusion, and specialized care, resulting in lower mortality and better outcomes. Conversely, low-resource settings face higher mortality due to limited resources, less frequent monitoring, and less aggressive treatment protocols. Innovations like point-of-care ultrasound and telemedicine show promise in bridging these gaps.</p>

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Managing Neurological Complications in Pediatric Diabetic Ketoacidosis: Insights from Low-Resource Emergency Departments and Comparisons with High-Resource Settings: A Narrative Review

  • 期刊论文

  • 发表日期：

    2025年6月6日

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  • Marina Ramzy Mourid,
  • Victor N. Oboli,
  • Paviter Gill,
  • Reshma Pyala,
  • Syeda AlishahZehra,
  • Luis L Gamboa,
  • Mohammed Alsabri

摘要

Purpose of Review

Pediatric diabetic ketoacidosis (DKA) poses significant risks, including severe neurological complications such as cerebral edema, which impacts mortality and long-term outcomes. Disparities in management between low-resource and high-resource settings highlight differences in treatment protocols and patient outcomes. This review aims to compare the management of pediatric DKA and associated neurological complications between low-resource and high-resource settings and to identify strategies to improve outcomes in diverse healthcare environments.

Recent Findings

A widespread search was conducted using databases PubMed, Scopus, Web of Science, and Google Scholar for studies from January 2010 to June 2024 with these keywords: diabetic ketoacidosis (DKA); pediatric; cerebral edema; neurologic complications; management protocols. Inclusion criteria focused on English-language studies on DKA management and neurological outcomes in pediatric populations. Both low-resource and high-resource settings were analyzed. Effective management of pediatric DKA requires early intervention and adherence to protocols. Disparities between settings necessitate further research on cost-effective solutions and implementation strategies to improve care globally.

Summary

High-resource settings benefit from advanced diagnostics, continuous insulin infusion, and specialized care, resulting in lower mortality and better outcomes. Conversely, low-resource settings face higher mortality due to limited resources, less frequent monitoring, and less aggressive treatment protocols. Innovations like point-of-care ultrasound and telemedicine show promise in bridging these gaps.