PMID: 2507798Oct 20, 1989Paper

Salutary effects of modest fluid replacement in the treatment of adults with diabetic ketoacidosis. Use in patients without extreme volume deficit

JAMA : the Journal of the American Medical Association
H J AdroguéG Eknoyan

Abstract

The optimal rate of fluid administration to correct the volume deficit associated with diabetic ketoacidosis remains undefined. Thus, this study evaluates prospectively in adult patients without extreme volume deficit two regimens of therapy that differed exclusively in the rate of fluid infusion. In protocol 1 (12 patients), normal saline was infused at 1000 mL/h (approximately 14 mL/kg per hour) in the initial 4 hours and 500 mL/h (approximately 7 mL/kg per hour) during the subsequent 4 hours. In protocol 2 (11 patients), normal saline was infused at half the rates of protocol 1. For plasma bicarbonate level, the increment from admission levels at 2, 4, 8, 16, and 24 hours after admission was greater with protocol 2 at all times, attaining a statistically significant difference at 4 hours (3.7 vs 0.7 mmol/L) and at 24 hours (13.2 vs 8.4 mmol/L). These data support cautious restraint in the volume of fluid replacement used in the therapy of diabetic ketoacidosis, since prompt recovery, lack of any harmful effects, and a significant reduction in the overall cost of medical therapy are achieved with lower rates of saline infusion.

Citations

Aug 29, 1992·BMJ : British Medical Journal·C Johnston
May 23, 2002·Archives of Disease in Childhood·C D Inward, T L Chambers
May 16, 2003·Emergency Medicine Journal : EMJ·R D Hardern, N D Quinn
Jan 23, 2004·Archives of Disease in Childhood·D B DungerUNKNOWN LWPES
May 13, 2004·Postgraduate Medical Journal·P English, G Williams
May 16, 2002·Current Opinion in Pediatrics·Desmond Bohn, Denis Daneman
Jan 10, 2001·Endocrinology and Metabolism Clinics of North America·M F DelaneyW M Kettyle
Jan 11, 2000·Critical Care Medicine·A ViallonJ C Bertrand
May 17, 2002·Journal of Diabetes and Its Complications·Irma FiordalisiM G F Gilliland
Apr 29, 2014·Emergency Medicine Clinics of North America·Brian CorwellGeorge C Willis
Nov 9, 2010·Advances in Pediatrics·Arleta Rewers
Jan 1, 1992·Baillière's Clinical Endocrinology and Metabolism·W Berger, U Keller
Oct 31, 2007·Journal of Diabetes and Its Complications·Antonios H TzamaloukasGlen H Murata
Nov 28, 2006·Diabetes Research and Clinical Practice·Otto M HenriksenOle Lander Svendsen
Mar 8, 2007·Pediatric Diabetes·Joseph WolfsdorfUNKNOWN International Society for Pediatric and Adolescent Diabetes
Aug 3, 2012·Journal of Veterinary Emergency and Critical Care·Benjamin M BrainardUNKNOWN RECOVER Monitoring Domain Worksheet Authors
Jul 13, 2005·Pediatric Clinics of North America·Michael S D Agus, Joseph I Wolfsdorf
Sep 8, 2005·Expert Opinion on Pharmacotherapy·Haralampos J Milionis, Moses S Elisaf
Apr 29, 1999·Diabetic Medicine : a Journal of the British Diabetic Association·K G Alberti
Feb 3, 1998·Pediatric Pulmonology·D S Holsclaw, B Torcato
May 23, 2000·Diabetic Medicine : a Journal of the British Diabetic Association·R Matz
Sep 17, 2009·Pediatric Diabetes·Joseph WolfsdorfRagnar Hanas
Aug 29, 1992·BMJ : British Medical Journal·M R Kiln
Aug 29, 1992·BMJ : British Medical Journal·K Cullen
Jul 1, 1997·Clinical Pediatrics·B H Brouhard
Jan 12, 2005·Acta Clinica Belgica·G Decaux
Sep 1, 1994·Postgraduate Medicine·Lisa H Fish
Apr 1, 1997·Postgraduate Medicine·D S Bell, J Alele
Feb 24, 2001·Diabetes Care·A E KitabchiB M Wall
Sep 1, 1992·Clinical Pediatrics·N ShabbirL S Levine
Sep 29, 2020·Frontiers in Medicine·Todd S IngAntonios H Tzamaloukas
Jul 1, 2017·Frontiers in Endocrinology·Tara T T TranElif I I Ekinci
Feb 25, 2021·The American Journal of Emergency Medicine·Brit LongMichael Gottlieb
Jul 1, 2021·Diabetes Care·Arleta RewersUNKNOWN Pediatric Emergency Care Applied Research Network (PECARN) FLUID Study Group

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.