Acta Scientific Clinical Case Reports

Review Article Volume 2 Issue 12

Accelerated Starvation of Childhood in the Paediatric Emergency Department

Katri Sandholm1 and Ruth M Löllgen1-4*

1Paediatric Emergency Department, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
2Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
3Emergency Department, Royal Children’s Hospital, Melbourne, Australia
4Clinical Sciences, Murdoch Children’s Research Institute, Flemington Road, Parkville, Victoria, Australia

*Corresponding Author: Ruth M Löllgen, Paediatric Emergency Department, Astrid Lindgren Children's Hospital, Karolinska University Hospital and Department of Women's and Children's Health, Karolinska Institute, Stockholm, Swedsen, Sweden.

Received: October 07, 2021; Published: November 25, 2021

Abstract

Accelerated starvation of childhood (ASC) is a frequent, yet underrecognized condition in children presenting to the pediatric emergency department (PED). Typically, a prolonged fasting state resulting from an intercurrent illness or per-operative fasting periods causes hyperketonaemia with or without hypoglycaemia (≤3.9 mmol/L) and/or metabolic acidosis with distinctive clinical signs and symptoms including lethargy, nausea, abdominal pain, vomiting, or seizures and should prompt correction of ketosis with oral, nasogastric (NG) or intravenous (IV) glucose solution. We describe a case of ASC and discuss recognition and management of this condition in the PED based on a review of the literature.

Keywords: Accelerated Starvation of Childhood; Intravenous; Childhood; Starvation Ketosis; Children; Pediatric Emergency Departmen; Blood Ketone Bodies; Glucose Substitution

References

  1. Millar R and A Harding. “Review article: Accelerated starvation of childhood: Have I judged ketones?” EMA - Emergency Medicine Australasia3 (2019): 314-320.
  2. Van de Voorde P., et al. “European Resuscitation Council Guidelines 2021: Paediatric Life Support”. Resuscitation 161 (2021): 327-387.
  3. Eichler A., et al. “Ketoacidosis in a 14 month old child caused by fasting”. Anaesthesist11 (1999): 813-816.
  4. Levy JA., et al. “Value of point-of-care ketones in assessing dehydration and acidosis in children with gastroenteritis”. Academic Emergency Medicine 11 (2013): 1146-1150.
  5. Daly LP., et al. “Presenting features of idiopathic ketotic hypoglycemia”. Journal of Emergency Medicine1 (2003): 39-43.
  6. Abdelkreem E., et al. “Characterization and outcome of 11 children with non-diabetic ketoacidosis”. Journal of Pediatric Endocrinology and Metabolism 1 (2021): 95-102.
  7. Bai K., et al. “Pediatric non-diabetic ketoacidosis: a case-series report”. BMC Pediatrics1 (2017): 209.
  8. Dahl GT., et al. “Metabolic acidosis mimicking diabetic ketoacidosis after use of calorie-free mineral water”. European Journal of Pediatrics 9 (2012): 1405-1407.
  9. Niiya S., et al. “The effect of calories of preoperative oral intake on the glucose metabolic response in children”. Masui4 (1999): 362-367.

Citation

Citation: Katri Sandholm and Ruth M Löllgen. “Accelerated Starvation of Childhood in the Paediatric Emergency Department". Acta Scientific Clinical Case Reports 2.12 (2021): 49-51.

Copyright

Copyright: © 2021 Katri Sandholm and Ruth M Löllgen. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.278

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