Reevaluating bicarbonate therapy in pediatric DKA A propensity score-matched analysis of neurological and respiratory outcomes

Patel M, Afifi AM, Hercher RL, et al. Reevaluating bicarbonate therapy in pediatric DKA: A propensity score-matched analysis of neurological and respiratory outcomes. Am J Emerg Med. 2025 Jul;97:45-50. doi: 10.1016/j.ajem.2025.07.033. PMID: 40683034 | PMID: 40683034

This study evaluated the neurological and respiratory outcomes associated with bicarbonate therapy in pediatric patients with diabetic ketoacidosis using propensity score-matched analysis to control for confounding variables.

Key Learning Points

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  Bicarbonate therapy in pediatric DKA was not associated with improved neurological or respiratory outcomes in this matched cohort.
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  Clinicians should reconsider routine bicarbonate use in pediatric DKA given the lack of demonstrated benefit and potential risks.