The utility of ketones at triage: a prospective cohort study
Files in This Item:
|Download||Ketones in Children - Infection Related Illness -Archives v1.pdf||421.81 kB||Adobe PDF|
|Title:||The utility of ketones at triage: a prospective cohort study||Other Titles:||Ketones in non-diabetic children with vomiting, diarrhoea or reduced intake: a prospective cohort study||Authors:||Durnin, Sheena; Jones, Jennifer; Ryan, Emer; Barrett, Michael; et al.||Permanent link:||http://hdl.handle.net/10197/12342||Date:||20-Nov-2020||Online since:||2021-07-23T15:21:41Z||Abstract:||Objective: To establish the relationship between serum point-of-care (POC) ketones at triage with clinical dehydration based on the validated Gorelick scales. Design, setting and patients: Prospective unblinded exploratory study fromApril 2016 to February 2017in a tertiary paediatric Emergency Department. Patients aged 1 month to 5 years, with vomiting and/or diarrhoea and/or decreased intake with signs of dehydration or clinical concern for hypoglycaemia were eligible. Main outcome measures: POC ketones were analysed at triage and 4-hours later or upon discharge if earlier.Secondary outcomes were to examine the response of ketone levels to fluid/glucose administration and patient disposition. Results:Two-hundred and one attendances were included(198 patients); median age 1.8years. The median triage ketones were 4.4 (interquartile range (IQR) 2.8–5.6) mmol/L. Aweak correlation was identified between triage ketones and 10-point Gorelick scale (Pearson r=0.215), however the 4-point Gorelick scale was non-significant. Those admitted to hospital had median triage ketones of 5.2 (IQR 5-6) mmol/L and repeat ketones of 4.6 (IQR 3.3-5.7) mmol/L compared to 4.2 (IQR 2.4–5.2) mmol/Land 2.9 (IQR 1.6–4.2) mmol/L in those discharged home. Conclusion: Elevated POC ketones were demonstrated in non-diabetic childrenwith acute illness. A weak correlation was demonstrated between triage POC ketones and the 10-point Gorelick scale, however,this was not demonstrated with the 4-point Gorelick scale. The use of POC ketones, at triage and at 4-hours,to predict the patient’s disposition had poor and fair accuracy respectively. Ketosis and the potential impact of tailored treatments in paediatric acute illness warrants further research.||Type of material:||Journal Article||Publisher:||BMJ||Journal:||Archives of Disease in Childhood||Volume:||105||Issue:||12||Start page:||1157||End page:||1161||Copyright (published version):||2020 the Authors||Keywords:||Serum point-of-care ketones; Triage; Dehydration; Pediatric emergency care; Hypoglycaemia; Gorelick scales||DOI:||10.1136/archdischild-2019-318425||Language:||en||Status of Item:||Peer reviewed||ISSN:||0003-9888||This item is made available under a Creative Commons License:||https://creativecommons.org/licenses/by-nc-nd/3.0/ie/|
|Appears in Collections:||Medicine Research Collection|
Show full item record
If you are a publisher or author and have copyright concerns for any item, please email firstname.lastname@example.org and the item will be withdrawn immediately. The author or person responsible for depositing the article will be contacted within one business day.