title: Plasma-Lyte 148 vs 0.9% saline for fluid resuscitation in diabetic ketoacidosis.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.affiliation: Department of Intensive Care, Austin Hospital, Melbourne, Australia.
authors.forename: Horng-Ruey
authors.initials: HR
authors.lastname: Chua
authors.forename: Balasubramanian
authors.initials: B
authors.lastname: Venkatesh
authors.forename: Edward
authors.initials: E
authors.lastname: Stachowski
authors.forename: Antoine G
authors.initials: AG
authors.lastname: Schneider
authors.forename: Kelly
authors.initials: K
authors.lastname: Perkins
authors.forename: Suzy
authors.initials: S
authors.lastname: Ladanyi
authors.forename: Peter
authors.initials: P
authors.lastname: Kruger
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Bellomo
mesh_terms: D000328:Adult; D016883:Diabetic Ketoacidosis / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D005942:Gluconates / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007362:Intensive Care Units; D015636:Magnesium Chloride / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011189:Potassium Chloride / Q000009:adverse effects / Q000627:therapeutic use; D012151:Resuscitation / Q000379:methods*; D012189:Retrospective Studies; D019346:Sodium Acetate / Q000009:adverse effects / Q000627:therapeutic use; D012965:Sodium Chloride / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005942:Gluconates; C012499:Plasma-lyte 148; D015636:Magnesium Chloride; D012965:Sodium Chloride; D019346:Sodium Acetate; D011189:Potassium Chloride