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Master Thesis

Intérêt de la cétonémie capillaire comme facteur prédictif du mode de réhydratation dans les gastroentérites aiguës chez l’enfant de 3 mois à 5 ans : établissement d’une valeur seuil

Abstract : Context: Acute gastroenteritis in children population aged 3 months to 5 years led to 750 000 consultations in general practice in France in 2013, and to 18 000 hospitalizations. There is a relevant relationship between serum ketone concentration and the level of serum bicarbonates concentration (HCO3-), a recognized biological indicator of dehydration. Our hypothesis was that the value of serum ketone concentration was correlated to the final care per os (OS), by nasogastric or intravenous tubes (NG/IV) and that there could be a ketonemia threshold value that could help medical decisions. Patients and methods: A retrospective monocentric study was undertaken from 11/26/2014 until 02/14/2015. It included children aged from 3 months to 5 years, with a light to medium dehydration and a blood ketonemia value measured at the emergency room. The main selection criterion was the blood ketonemia predictive value according the final care-taking of the child. Results: 130 patients were included, 95 had a PO rehydration and 35 by SNG/IV. There is a significant statistical difference between the ketonemia value in the PO and SNG/IV groups with a p-value= 0,009 IC95[0.24;1.66]. With a threshold value at 3,5mmol/L there was a 82% specificity and a 32% sensibility, in other words, a NPV at 0,43 and a PPV at 0,78. Conclusion: This study suggests the importance of blood ketonemia in children population aged 3 months to 5 years old, with a light to medium dehydration during a gastro-enteritis episode. When admitted to the emergency room, this could allow for a quick and tailored therapeutic decision, with several additional benefits: reliability of the interindividual values, swiftness of execution and good tolerance.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01164030
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Submitted on : Tuesday, June 16, 2015 - 9:38:50 AM
Last modification on : Tuesday, May 11, 2021 - 11:36:17 AM
Long-term archiving on: : Tuesday, April 25, 2017 - 8:30:51 AM

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  • HAL Id : dumas-01164030, version 1

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Flavie Colin, Julie Pinczon. Intérêt de la cétonémie capillaire comme facteur prédictif du mode de réhydratation dans les gastroentérites aiguës chez l’enfant de 3 mois à 5 ans : établissement d’une valeur seuil. Médecine humaine et pathologie. 2015. ⟨dumas-01164030⟩

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