Plasma-Lyte 148 vs 0.9% saline for fluid resuscitation in diabetic ketoacidosis.
Details
Serval ID
serval:BIB_6D3D93D74796
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Plasma-Lyte 148 vs 0.9% saline for fluid resuscitation in diabetic ketoacidosis.
Journal
Journal of Critical Care
ISSN
1557-8615 (Electronic)
ISSN-L
0883-9441
Publication state
Published
Issued date
2012
Peer-reviewed
Oui
Volume
27
Number
2
Pages
138-145
Language
english
Notes
Publication types: Comparative Study ; Evaluation Studies ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't Publication Status: ppublish
Abstract
PURPOSE: The purpose of the study was to determine the effects of Plasma-Lyte 148 (PL) vs 0.9% saline (NS) fluid resuscitation in diabetic ketoacidosis (DKA).
METHODS: A multicenter retrospective analysis of adults admitted for DKA to the intensive care unit, who received almost exclusively PL or NS infusion up until 12 hours, was performed.
RESULTS: Nine patients with PL and 14 patients with NS were studied. Median serum bicarbonate correction was higher in the PL vs NS groups at 4 to 6 hours (8.4 vs 1.7 mEq/L) and 6 to 12 hours (12.8 vs 6.2 mEq/L) from baseline (P < .05). Median standard base excess improved by 10.5 vs 4.2 mEq/L at 4 to 6 hours and by 16.0 vs 9.1 mEq/L at 6 to 12 hours in the PL and NS groups, respectively (P < .05). Chloride levels increased significantly in the NS vs PL groups over 24 hours. Potassium levels were lower at 6 to 12 hours in the PL group. Mean arterial blood pressure was higher at 2 to 4 hours in the PL group, whereas cumulative urine output was lower at 4 to 6 hours in the NS group. There were no differences in glycemic control or duration of intensive care unit stay.
CONCLUSION: Patients with DKA resuscitated with PL instead of NS had faster initial resolution of metabolic acidosis and less hyperchloremia, with a transiently improved blood pressure profile and urine output.
METHODS: A multicenter retrospective analysis of adults admitted for DKA to the intensive care unit, who received almost exclusively PL or NS infusion up until 12 hours, was performed.
RESULTS: Nine patients with PL and 14 patients with NS were studied. Median serum bicarbonate correction was higher in the PL vs NS groups at 4 to 6 hours (8.4 vs 1.7 mEq/L) and 6 to 12 hours (12.8 vs 6.2 mEq/L) from baseline (P < .05). Median standard base excess improved by 10.5 vs 4.2 mEq/L at 4 to 6 hours and by 16.0 vs 9.1 mEq/L at 6 to 12 hours in the PL and NS groups, respectively (P < .05). Chloride levels increased significantly in the NS vs PL groups over 24 hours. Potassium levels were lower at 6 to 12 hours in the PL group. Mean arterial blood pressure was higher at 2 to 4 hours in the PL group, whereas cumulative urine output was lower at 4 to 6 hours in the NS group. There were no differences in glycemic control or duration of intensive care unit stay.
CONCLUSION: Patients with DKA resuscitated with PL instead of NS had faster initial resolution of metabolic acidosis and less hyperchloremia, with a transiently improved blood pressure profile and urine output.
Keywords
Adult, Diabetic Ketoacidosis/therapy, Female, Fluid Therapy/methods, Gluconates/adverse effects, Gluconates/therapeutic use, Humans, Intensive Care Units, Magnesium Chloride/adverse effects, Magnesium Chloride/therapeutic use, Male, Middle Aged, Potassium Chloride/adverse effects, Potassium Chloride/therapeutic use, Resuscitation/methods, Retrospective Studies, Sodium Acetate/adverse effects, Sodium Acetate/therapeutic use, Sodium Chloride/adverse effects, Sodium Chloride/chemistry, Treatment Outcome, Young Adult
Pubmed
Web of science
Create date
26/11/2014 22:54
Last modification date
20/08/2019 15:26