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Fluid DKA saline ringer

Daniel S Hsia, Sarah G Tarai, Amir Alimi, Jorge A Coss-Bu, Morey W Haymond
OBJECTIVE: To compare outcomes of diabetic ketoacidosis (DKA) 6 yrs before and 6 yrs after changing rehydration fluids from ½ normal saline to Lactated Ringer's and decreasing the total intended fluid volume administered in the first 24 hrs from 3500 mL/m(2) /d to ≤ 2500 mL/m(2) /d at Texas Children's Hospital (TCH) in response to recommendations by the ESPE, LWPES, and ISPAD in 2004. SUBJECTS/METHODS: A retrospective cohort study was conducted in which 1868 admissions for DKA were identified and reviewed...
August 2015: Pediatric Diabetes
D G Van Zyl, P Rheeder, E Delport
OBJECTIVE: To determine if Ringer's lactate is superior to 0.9% sodium chloride solution for resolution of acidosis in the management of diabetic ketoacidosis (DKA). DESIGN: Parallel double blind randomized controlled trial. METHODS: Patients presenting with DKA at Kalafong and Steve Biko Academic hospitals were recruited for inclusion in this study if they were >18 years of age, had a venous pH >6.9 and ≤7.2, a blood glucose of >13 mmol/l and had urine ketones of ≥2+...
April 2012: QJM: Monthly Journal of the Association of Physicians
Paul Bradley, Joseph D Tobias
BACKGROUND: Despite literature outlining suggested initial therapy for pediatric patients with diabetic ketoacidosis (DKA), our impression has been that there may be variations from these recommendations during the initial therapy of pediatric patients with DKA. In order to improve education initiatives, an understanding of the deviations from current practice is required. METHODS: Patients admitted to the pediatric intensive care unit with a diagnosis of DKA were identified from the admission log...
November 2008: American Journal of Therapeutics
Wendy C Matsuno, Loren G Yamamoto
Many published reports state that the type of resuscitation fluid to be used for volume expansion should be "isotonic crystalloid" or "isotonic fluid". Generally, this terminology refers to normal saline (NS) and lactated Ringer's (LR) solution. This terminology is suboptimal technically since not all "isotonic" crystalloids are sufficient volume expanders. A total of 48 reference books from the areas of general pediatrics, pediatric emergency medicine, emergency medicine, pediatric critical care, pediatric surgery, general surgery, internal medicine, family medicine, adult critical care, obstetrics and gynecology, endocrinology, and life support course manuals were reviewed...
March 2006: Resuscitation
K I Rother, W F Schwenk
OBJECTIVE: To evaluate whether rehydration of young patients with diabetic ketoacidosis (DKA) by use of a solution that contained 75 mmol/L of sodium would be associated with a decline in serum sodium concentrations. DESIGN: We retrospectively studied 18 episodes of moderate to severe DKA (mean plasma bicarbonate concentration of 7.8 +/- 0.9 mmol/L) in 17 patients younger than 18 years of age who had been examined at the Mayo Clinic between 1986 and 1990. MATERIAL AND METHODS: All patients had received an initial fluid bolus (about 20 mL/kg) of 0...
December 1994: Mayo Clinic Proceedings
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