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Title: Plasma-Lyte 148 vs 0.9% saline for fluid resuscitation in diabetic ketoacidosis.
Austin Authors: Chua, Horng-Ruey;Venkatesh, Balasubramanian;Stachowski, Edward;Schneider, Antoine G;Perkins, Kelly;Ladanyi, Suzy;Kruger, Peter;Bellomo, Rinaldo 
Affiliation: Department of Intensive Care, Austin Hospital, Melbourne, Australia
Issue Date: 1-Apr-2012
Publication information: Journal of Critical Care; 27(2): 138-45
Abstract: 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).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.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.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.
Gov't Doc #: 22440386
DOI: 10.1016/j.jcrc.2012.01.007
Type: Journal Article
Subjects: Adult
Diabetic Ketoacidosis.therapy
Fluid Therapy.methods
Gluconates.adverse effects.therapeutic use
Intensive Care Units
Magnesium Chloride.adverse effects.therapeutic use
Middle Aged
Potassium Chloride.adverse effects.therapeutic use
Retrospective Studies
Sodium Acetate.adverse effects.therapeutic use
Sodium Chloride.adverse effects.chemistry.therapeutic use
Treatment Outcome
Young Adult
Appears in Collections:Journal articles

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