Saving a 9-year-old girl in a deep coma due to ketoacidosis

SGGPO 09/19/2023 10:17

On the morning of September 19, Ha Tinh General Hospital announced that pediatricians had just saved the life of a 9-year-old girl who was in a deep coma and suffering from rare diabetic ketoacidosis.

After receiving intensive treatment, the NTKN patient was conscious, able to sit up and walk.

Patient NTKN (9 years old, residing in Huong Khe town, Huong Khe district, Ha Tinh province) was admitted to the hospital with symptoms of coma, difficulty breathing, and rapid, shallow breathing. The patient's family said that 3 weeks ago, the child lost weight very quickly, from 37kg to 32kg for unknown reasons; recently the child appeared to vomit, feel tired... so the family took the child to Huong Khe District General Hospital. On September 15, the child was transferred to Ha Tinh Provincial General Hospital.

After being admitted, the patient's condition worsened, such as drowsiness, coma, rapid shallow breathing... immediately, the doctors of the Pediatrics Department (Ha Tinh General Hospital) performed oxygen mask, endotracheal intubation, mechanical ventilation, and invasive arterial BP placement....

Emergency blood tests showed that capillary blood sugar was unmeasurable (HI), blood gas pH was 6.8, venous blood sugar was 59 mmol/l (normal is 3.4-6.2 mmol/l)... so continuous insulin infusion was performed.

At the same time, a red alert was issued for the entire hospital to reach a consensus on the diagnosis: Deep coma - diabetic ketoacidosis/severe infection - monitoring for sepsis. At the same time, the doctors of the Pediatrics Department also consulted with leading experts of the National Children's Hospital to come up with the best treatment plan for the child.

Deputy Director of Ha Tinh General Hospital and related departments consulted and developed an emergency treatment plan for NTKN patient.

After a period of intensive treatment, the blood sugar index returned to 17 mmol/l and the severe ketoacidosis index returned from pH 6.8 to normal (pH 7.36), the patient was conscious and the endotracheal tube was removed.

After that, the patient continued to consult with the Endocrinology Department (Ha Tinh General Hospital) as well as the National Children's Hospital to continue treatment according to the regimen. After the consultation, the doctors agreed to switch to Insulin injection dose of 4 injections/day.

Dr. Duong Van Giap, Deputy Head of the Department of Pediatrics (Ha Tinh General Hospital) warned that although diabetes in children is rare, complications of ketoacidosis coma can progress severely, leading to death if not detected early and treated promptly.

Therefore, if parents discover that their children eat a lot, drink a lot, urinate a lot, or lose weight, they need to take them to a medical facility with a specialist for examination and timely diagnosis and treatment to avoid unfortunate complications.

Besides, to prevent diabetes in children, it is necessary to have a healthy, scientific diet, rich in fiber and increase physical activity for children.

Source: https://www.sggp.org.vn/cuu-song-be-gai-9-tuoi-hon-me-sau-do-nhiem-toan-ceton-post706159.html