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
Title
Plasma-Lyte 148 vs 0.9% saline for fluid resuscitation in diabetic ketoacidosis.
Journal
Journal of Critical Care
Author(s)
Chua H.R., Venkatesh B., Stachowski E., Schneider A.G., Perkins K., Ladanyi S., Kruger P., Bellomo R.
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.
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
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