Hyperlactatemia associated with diabetic ketoacidosis in pediatric intensive care unit

Abstract

Background: Children with diabetic ketoacidosis often have elevated lactate. In this study, we investigated the clinical variables associated with hyperlactatemia in children with diabetic ketoacidosis.

Methods: We designed a single-center retrospective descriptive study of children with diabetic ketoacidosis in a pediatric intensive care unit.

Results: Of the 107 patients with diabetic ketoacidosis included in the analysis, 61 developed hyperlactatemia. Multivariate logistic regression analysis showed that heart rate (p = 0.003),diastolic blood pressure (p = 0.001) and stage of severity (p = 0.042) were independently associated with the development of hyperlactatemia in diabetic ketoacidosis. We found that lactate level was not significantly associated with length of hospital stay (p = 0.115) or the length of time to diabetic ketoacidosis resolution (p = 0.143).

Conclusions: Children with diabetic ketoacidosis presenting with severer stage, elevated heart rate and higher diastolic blood pressure may be prone to hyperlactatemia. Hyperlactatemia was not associated with length of time to DKA resolution and length of hospital stay.

Keywords: Diabetes mellitus; Diabetic ketoacidosis; Lactate.

Fig. 1

Lactate levels and hospital length of stay. In patients with DKA, lactate was not associated with hospital length of stay (r = 0.154, p = 0.115)

Fig. 2

Lactate levels and the length of time to resolution of DKA. In patients with DKA, lactate was not associated with the length of time to resolution of DKA (r = 0.143, p = 0.143)