ISSN 1306-0015 | E-ISSN 1308-6278
Original Article
Electrocardiographic changes in children with diabetic ketoacidosis and ketosis
1 Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Istanbul, Turkey  
2 Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Cardiology, Istanbul, Turkey  
3 Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Istanbul, Turkey  
4 Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Intensive Care, Istanbul, Turkey  
Turk Pediatri Ars 2017; 52: 194-201
DOI: 10.5152/TurkPediatriArs.2017.4917
Key Words: Diabetic ketoacidosis, electrocardiography, ketosis, QTc length
Abstract

Aim: We aimed to study electrocardiographic changes in children with diabetic ketoacidosis and ketosis and to evaluate the relation of the changes with serum electrolyte levels and ketosis.

 

Material and Methods: This study was performed in Istanbul Medical Faculty, Pediatric Emergency and Intensive Care Department between May 2008 and May 2009. The electrocardiographic parameters and QT length of children with diabetic ketoacidosis and ketosis were evaluated at diagnosis and after the treatment.

 

Results: Forty patients were included in the study; 16 (40%) were diagnosed as having diabetic ketosis and 24 (60%) had diabetic ketoacidosis. Twenty-four (60%) patients were male and 16 (40%) were female and the mean age was 9.21±4.71 years (range, 1-16 years). Twelve (30%) cases of diabetic ketoacidosis were mild, three (7.5%) were moderate, and nine (22.5%) were severe. One patient had premature ventricular beats, and four had ST depression. The electrocardiographic parameters were all normal beyond the QTC length prolongation. The mean QTC length was 447±45 ms (380-560 ms) at diagnosis and 418±32 ms (350-500 ms) after treatment. The change in the QTC length was statistically significant. None of the patients had significant electrolyte disturbance and the prolongation of QTc length was not correlated with serum electrolyte levels. The prolongation of QTc length was statistically correlated with anion gap (r=0.33, p=0.03).

 

Conclusions: In our study, we showed QTc length prolongation and the importance of performing electrocardiography during the diagnosis of diabetic ketoacidosis and ketosis. We also demonstrated that ketosis was responsible for the prolongation of QTc length.  

 

 

Cite this article as: Aygün D, Aygün F, Nişli K, Baş F, Çıtak A. Electrocardiographic changes in children with diabetic ketoacidosis and ketosis. Turk Pediatri Ars 2017; 52: 194-201.

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