{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T10:59:05Z","timestamp":1740135545063,"version":"3.37.3"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T00:00:00Z","timestamp":1679270400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T00:00:00Z","timestamp":1679270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Endocr Disord"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus. DKA associated with shock is a rare condition that occurs due to the fluid deficit or septic shock. It is not easy to differentiate these two conditions by clinical judgment and laboratory findings. Although the fluid therapy is the mainstay in DKA treatment, it looks like a double-edged sword\u2014underhydration may result in organ failure whereas overhydration may lead to pulmonary and cerebral edema (CE).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>Herein, we report on two pediatric patients presenting with DKA and septic shock. The first patient was an 8-year-old boy newly diagnosed with type 1 diabetes mellitus (T1DM) who presented with DKA and septic shock. We used a device for continuous hemodynamic monitoring (proAQT) to estimate his volume status. The patient was extubated 48\u2009hours of hospitalization; the DKA was resolved after 52\u2009hours of admission. He was discharged home in good condition on the 5th day. The second patient was a 13-year-old girl, a known case of T1DM, who presented with mixed DKA- hyperosmolar-hyperglycemic state (HHS) and septic shock. She was intubated and treated according to the data derived from pulse Contour Cardiac Output (PiCCO). After 3 days, she was extubated and transferred to the ward in good condition.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Using invasive hemodynamic monitoring in critically ill children with severe DKA and hypotension might guide the physicians for hydration and selecting the most appropriate inotrope.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12902-023-01315-4","type":"journal-article","created":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T17:02:49Z","timestamp":1679331769000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment of septic shock in two pediatric patients with severe diabetic ketoacidosis using invasive hemodynamic monitoring: a case report"],"prefix":"10.1186","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9864-3087","authenticated-orcid":false,"given":"Amir","family":"Saeed","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6651-7414","authenticated-orcid":false,"given":"Fateme","family":"Ziyaee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,3,20]]},"reference":[{"issue":"Suppl 27","key":"1315_CR1","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1111\/pedi.12701","volume":"19","author":"JI Wolfsdorf","year":"2018","unstructured":"Wolfsdorf JI, Glaser N, Agus M, et al. ISPAD clinical practice consensus guidelines 2018: diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Pediatr Diabetes. 2018;19(Suppl 27):155\u201377.","journal-title":"Pediatr Diabetes"},{"issue":"19","key":"1315_CR2","doi-asserted-by":"publisher","first-page":"2511","DOI":"10.1001\/jama.287.19.2511","volume":"287","author":"A Rewers","year":"2002","unstructured":"Rewers A, Chase HP, Mackenzie T, et al. Predictors of acute complications in children with type 1 diabetes. JAMA. 2002;287(19):2511\u20138.","journal-title":"JAMA"},{"issue":"5","key":"1315_CR3","first-page":"299","volume":"14","author":"L Barski","year":"2012","unstructured":"Barski L, Nevzorov R, Rabaev E, et al. Diabetic ketoacidosis: clinical characteristics, precipitating factors and outcomes of care. 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Pediatr Crit Care Med. 2012;13(2):e103\u20137.","journal-title":"Pediatr Crit Care Med"},{"issue":"12","key":"1315_CR6","doi-asserted-by":"publisher","first-page":"362","DOI":"10.15585\/mmwr.mm6712a3","volume":"67","author":"SR Benoit","year":"2018","unstructured":"Benoit SR, Zhang Y, Geiss LS, Gregg EW, Albright A. Trends in diabetic ketoacidosis hospitalizations and in-hospital mortality - United States, 2000-2014. MMWR Morb Mortal Wkly Rep. 2018;67(12):362\u20135.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"5","key":"1315_CR7","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1097\/01.PCC.0000137987.74235.5E","volume":"5","author":"M Jayashree","year":"2004","unstructured":"Jayashree M, Singhi S. Diabetic ketoacidosis: predictors of outcome in a pediatric intensive care unit of a developing country. 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World J Diabetes. 2014;5(6):932\u20138.","journal-title":"World J Diabetes"}],"container-title":["BMC Endocrine Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-023-01315-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12902-023-01315-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-023-01315-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T17:03:18Z","timestamp":1679331798000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcendocrdisord.biomedcentral.com\/articles\/10.1186\/s12902-023-01315-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,20]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["1315"],"URL":"https:\/\/doi.org\/10.1186\/s12902-023-01315-4","relation":{},"ISSN":["1472-6823"],"issn-type":[{"type":"electronic","value":"1472-6823"}],"subject":[],"published":{"date-parts":[[2023,3,20]]},"assertion":[{"value":"25 March 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 March 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 March 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The protocol and patient informed consent forms were reviewed and approved by the local Ethics Committee of Shiraz University of Medical Sciences (Code: IR.SUMS.MED.REC.1398.201). The parents of studied patients signed the informed consent and granted permission to participate in the study and publish the data.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Children\u2019s parent or legal guardian gave their consent for the publication of identifiable details, which can include photograph(s) and\/or videos and\/or case history and\/or details within the text (\u201cMaterial\u201d) to be published in the above Journal. Publisher has the author\u2019s permission to publish research findings.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"No conflict of interest is declared by all authors.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"65"}}