What is the protocol for DKA?
Most protocols call for an initial bolus of isotonic crystalloid solution (0.9% saline) at a starting rate of 15–20 mL/kg/h (1–1.5 L/h) for the first hour. Following the initial hydration, fluids can be administered at a decreased rate of 4–14 mL/kg/h.
What is the most appropriate treatment for DKA?
The major treatment of this condition is initial rehydration (using isotonic saline) with subsequent potassium replacement and low-dose insulin therapy. The use of bicarbonate is not recommended in most patients.
What are the basic principles of DKA management?
The basic principles of DKA management include rapid restoration of adequate circulation and perfusion with isotonic intravenous fluids, gradual rehydration and restoration of depleted electrolytes, insulin to reverse ketosis and hyperglycaemia and regular monitoring of clinical signs and laboratory tests to detect and …
What IV fluids are given for DKA?
Normal saline (0.9% sodium chloride) is the most commonly used intravenous fluid in treating DKA, but it has a very high concentration of chloride and can lead to additional acid production when given in large volumes.
Which insulin is given in DKA?
Our results indicate that treatment of DKA with SC aspart insulin every 1 or 2 h is as safe and effective as the treatment with IV regular insulin. The rate of decline of blood glucose concentration and the mean duration of treatment until correction of ketoacidosis were similar among different treatment groups.
Why is potassium given in DKA?
After insulin treatment is initiated, potassium shifts intracellularly and serum levels decline. Replacement of potassium in intravenous fluids is the standard of care in treatment of DKA to prevent the potential consequences of hypokalemia including cardiac arrhythmias and respiratory failure.
Which insulin is used for diabetic ketoacidosis?
Only short-acting insulin is used for correction of hyperglycemia in DKA. The optimal rate of glucose decline is 100 mg/dL/h. The blood glucose level should not be allowed to fall lower than 200 mg/dL during the first 4-5 hours of treatment.
Why do you give dextrose in DKA?
Why is IV dextrose given to patients with DKA? When the serum glucose reaches 200 mg/dL in a patient with diabetic ketoacidosis (DKA), IV dextrose is added to avoid the development of cerebral edema. In addition, the rate of insulin infusion may need to be slowed down to between 0.02 and 0.05 units/kg/hr.
Why NS is used in DKA?
Importance Saline (0.9% sodium chloride), the fluid most commonly used to treat diabetic ketoacidosis (DKA), can cause hyperchloremic metabolic acidosis. Balanced crystalloids, an alternative class of fluids for volume expansion, do not cause acidosis and, therefore, may lead to faster resolution of DKA than saline.