PP210 [Combined Organ Systems » Endocrine / Inborn metabolic disease]: 0.9% SALINE VERSUS RINGER’S LACTATE AS INITIAL FLUID IN CHILDREN WITH DIABETIC KETOACIDOSIS: A DOUBLE BLIND RANDOMIZED CONTROLLED TRIAL

Abstract

BACKGROUND AND AIM: Although therapeutic hypothermia in post cardiac arrest (PCA) patients is internationally debated, strong evidence demonstrates pyrexia is associated with poorer neurological outcomes 1 . Management in any PCA patient focuses upon the prevention of secondary brain injury by tight control of physiological parameters, including targeted temperature management (TTM) to avoid pyrexia 2 . Our aim was to review our adherence to TTM in patients admitted to PICU after out of hospital and in hospital cardiac arrest.METHOD: PCA patients from January 2017 to December 2020 were identified through previous data submission to PICANet© UK. Analysis through our electronic medical record was performed. Standards included targets of 100% for the application of a cooling mattress, maintenance of normothermia (core temperature 36.5-37.5ºC) and avoidance of pyrexia (defined as core temperature >38.0°C) in the first 72 hours PCA.RESULTS: 66 patients were included in the data analysis. 31 patients (47%) developed pyrexia within the first 72 hours PCA (31 patients). Pyrexia occurred across the 72 hours PCA and not only in the first 24 hours. Cooling mattresses, essential for TTM, were only used in 39 patients (59%) most commonly in response to a rising core temperature. CONCLUSIONS:Our findings are consistent with evidence that a significant proportion of PCA patients experience pyrexia episodes outside of clinical trials 3 . Most surface cooling devices have a lag between a rising temperature and cooling⁴. We therefore suggest the use of cooling devices should become a standard of care aiming for mild hypothermia 35.5-36.5ºC in order to avoid pyrexia.