Schulich school of Medicine and Dentistry logo Anesthesia and Perioperative Medicine Schulich School of Medicine & Dentistry

In the Literature: New Research from Our Faculty (Dr. Chris Harle)

Monday, February 25, 2013

Pediatr Crit Care Med. 2013 Feb 7.

Coagulation assessment in children with diabetic ketoacidosis. 

Tran TH, Al-Harfi I, Harle CC, Kahr WH, Morrison GC, Kornecki A.



To assess potential hypercoagulability during diabetic ketoacidosis in children.


A prospective, controlled pilot study.


University-affiliated pediatric critical care unit and emergency department in a tertiary care children's hospital.


Children (1-18 yr) admitted with an episode of diabetic ketoacidosis and healthy children as controls. All patients with diabetic ketoacidosis managed according to a preestablished protocol.


Thromboelastography was performed using citrated whole-blood samples drawn at the time of admission and upon biochemical and clinical resolution of diabetic ketoacidosis. Citrated whole-blood samples drawn from healthy nondiabetic children acted as control samples.


Fifteen patients (11.7 ± 4.1 yr) in the diabetic ketoacidosis group and 20 patients (8.9 ± 4.5 yr; p = 0.06) in the control group completed the study. Values for standard thromboelastography parameters (R and K time, α angle, maximum amplitude, coagulation index, and Ly30) in the diabetic ketoacidosis group, both on admission and resolution, were within the control range; thromboelastography profiles of diabetic ketoacidosis patients on admission were not significantly different from profiles obtained upon diabetic ketoacidosis resolution. The mean α-angle was significantly higher in known diabetic patients compared with newly diagnosed diabetics on admission; however, it still remained within the control normal range.


Thromboelastographic assay results do not reflect a hypercoagulable state in this group of children with diabetic ketoacidosis. Further investigation is required to examine the potential role of injured endothelium in the suspected hypercoagulability during diabetic ketoacidosis.

See the PubMed Record