Severe pediatric diabetic ketoacidosis with multi-organ dysfunction and complete recovery in a resource-limited setting: A case report

Table 3 Timeline of treatment

Time	Treatment
Day 1	Admission to ICU with severe DKA, shock severe acidosis and ketonuria
Day 2	Standard DKA management
Day 3	Worsening oliguria progressing to anuria
	Care was transferred under specialists
	Hemodialysis indicated
Day 4-6	Two episodes of generalized tonic clonic seizures
	Neuroimaging indicated and cerebral oedema was noted
	Mannitol, hypertonic saline and levetirecetam
Day 6	Cardiac arrest secondary to metabolic derangements and multi-organ dysfunction
	Successful resuscitation and the patient was intubated and mechanically ventilated
Day 7-10	Gradual neurological, renal, and metabolic improvement. Vasopressor and ventilatory support successfully weaned
Day 10	Transferred from ICU to paediatric ward
Day 11-37	Continued renal recovery, physiotherapy, nutritional rehabilitation and multidisciplinary follow up
Day 37	Discharged home in stable condition with complete neurological recovery and improving renal function

ICU: Intensive care unit; DKA: Diabetic ketoacidosis.