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Emergency Medical Minute


 

May 4, 2021

Contributor:  Aaron Lessen, MD

Educational Pearls:

  • Recent study looked at whether lactated ringers might be a better choice for fluid resuscitation in patients with DKA compared to normal saline
  • Normal saline can cause a hyperchloremic metabolic acidosis
  • Time to resolution of acidosis was 4 hours less with lactated ringers compared to normal saline
  • Time on an insulin drip decreased by about 4 hours with lactated ringers compared to normal saline
  • LR might be a better choice for fluid resuscitation in patients with DKA

References

Self WH, Evans CS, Jenkins CA, et al. Clinical Effects of Balanced Crystalloids vs Saline in Adults With Diabetic Ketoacidosis: A Subgroup Analysis of Cluster Randomized Clinical Trials. JAMA Netw Open. 2020;3(11):e2024596. doi:10.1001/jamanetworkopen.2020.24596

Summarized by John Spartz, MS3 | Edited by Erik Verzemnieks, MD