Plasma-Lyte 148 vs 0.9% saline for fluid resuscitation in diabetic ketoacidosis.

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.

• Authors: Horng-Ruey Chua, Balasubramanian Venkatesh, Edward Stachowski, Antoine G Schneider, Kelly Perkins, Suzy Ladanyi, Peter Kruger, Rinaldo Bellomo
• Journal: Journal of critical care (J Crit Care) Vol. 27 Issue 2 Pg. 138-45 (Apr 2012) ISSN: 1557-8615 [Electronic] United States
• PMID: 22440386 (Publication Type: Comparative Study, Evaluation Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Chemical References

• Gluconates
• Plasma-lyte 148
• Magnesium Chloride
• Sodium Chloride
• Sodium Acetate
• Potassium Chloride

Topics

• Adult
• Diabetic Ketoacidosis (therapy)
• Female
• Fluid Therapy (methods)
• Gluconates (adverse effects, therapeutic use)
• Humans
• Intensive Care Units
• Magnesium Chloride (adverse effects, therapeutic use)
• Male
• Middle Aged
• Potassium Chloride (adverse effects, therapeutic use)
• Resuscitation (methods)
• Retrospective Studies
• Sodium Acetate (adverse effects, therapeutic use)
• Sodium Chloride (adverse effects, chemistry, therapeutic use)
• Treatment Outcome
• Young Adult