Capnography in DKA

End-tidal carbon dioxide predicts the presence and severity of acidosis in children with diabetes

Acad Emerg Med. 2002 Dec;9(12):1373-8
Fearon DM, Steele DW.

CONCLUSIONS: End-tidal CO(2) is linearly related to HCO(3) and is significantly lower in children with DKA. If confirmed by larger trials, cut-points of 29 torr and 36 torr, in conjunction with clinical assessment, may help discriminate between patients with and without DKA, respectively.

Capnometry for noninvasive continuous monitoring of metabolic status in pediatric diabetic ketoacidosis

Crit Care Med. 2003 Oct;31(10):2539-43.
Garcia E, Abramo TJ, Okada P, Guzman DD, Reisch JS, Wiebe RA.

CONCLUSIONS: PetCO2 monitoring of patients with diabetic ketoacidosis provides an accurate estimate of PCO2. Noninvasive PetCO2 sampling may be useful in patients with diabetic ketoacidosis to allow for continuous monitoring of patients.

Bottom Line for EMS: Put your cannulas on hyperglycemic patients.


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