Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 29 , ISSUE 1 ( January, 2025 ) > List of Articles

EDITORIAL

Intravenous Fluid Prescription in Diabetic Ketoacidosis: Where is the Evidence?

Supradip Ghosh

Keywords : 0.9% saline, Balanced electrolyte solution, Diabetic ketoacidosis, Fluid resuscitation

Citation Information : Ghosh S. Intravenous Fluid Prescription in Diabetic Ketoacidosis: Where is the Evidence?. Indian J Crit Care Med 2025; 29 (1):10-11.

DOI: 10.5005/jp-journals-10071-24875

License: CC BY-NC 4.0

Published Online: 30-12-2024

Copyright Statement:  Copyright © 2025; The Author(s).


Abstract

PDF Share
  1. Diabetes Canada Clinical Practice Guidelines Expert Committee, Goguen J, Gilbert J. Hyperglycaemic Emergencies in Adults. Can J Diabetes 2018;42 Suppl 1:S109–S114. DOI: 10.1016/j.jcjd.2017.10.013.
  2. Ghosh S. Handbook of Intravenous Fluids. 1st ed. Singapore: Springer; 2022. Chapter 14, Fluid Management in Diabetic Ketoacidosis; pp. 279–295. DOI: 10.1007/978-981-19-0500-1_16.
  3. Kitabchi AE, Umpierrez GE, Miles JM, et al. Hyperglycaemic crises in adult patients with diabetes. Diabetes Care 2009; 32:1335–1343. DOI: 10.2337/dc09-9032.
  4. Dhatariya KK; Joint British Diabetes Societies for Inpatient Care. The management of diabetic ketoacidosis in adults-An updated guideline from the Joint British Diabetes Society for Inpatient Care. Diabet Med 2022;39(6): e14788. DOI: 10.1111/dme.14788.
  5. Chua HR, Venkatesh B, Stachowski E, Schneider AG, Perkins K, Ladanyi S, et al. Plasma-Lyte 148 vs 0.9% saline for fluid resuscitation in diabetic ketoacidosis. J Crit Care 2012;27(2):138–145. DOI: 10.1016/j.jcrc.2012.01.007.
  6. Chowdhury AH, Cox EF, Francis ST, Lobo DN. A randomized, controlled, double-blind crossover study on the effects of 2-L infusions of 0.9% saline and plasma-lyte® 148 on renal blood flow velocity and renal cortical tissue perfusion in healthy volunteers. Ann Surg 2012;256(1):18–24. DOI: 10.1097/SLA.0b013e318256be72.
  7. Raghunathan K, Shaw A, Nathanson B, Stürmer T, Brookhart A, Stefan MS, et al. Association between the choice of IV crystalloid and in-hospital mortality among critically ill adults with sepsis. Crit Care Med 2014;42(7):1585–1591. DOI: 10.1097/CCM.000000000000 0305.
  8. Zampieri FG, Machado FR, Veiga VC, Azevedo LCP, Bagshaw SM, Damiani LP, et al. Correction: Determinants of fluid use and the association between volume of fluid used and effect of balanced solutions on mortality in critically ill patients: A secondary analysis of the BaSICS trial. Intensive Care Med 2024;50(1):79–89. DOI: 10.1007/s00134-023-07264-9.
  9. Self WH, Evans CS, Jenkins CA, Brown RM, Casey JD, Collins SP, 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.
  10. Ramanan M, Attokaran A, Murray L, Bhadange N, Stewart D, Rajendran G, et al. Sodium chloride or Plasmalyte-148 evaluation in severe diabetic ketoacidosis (SCOPE-DKA): A cluster, crossover, randomized, controlled trial. Intensive Care Med 2021;47(11):1248–1257. DOI: 10.1007/s00134-021-06480-5.
  11. Kuppermann N, Ghetti S, Schunk JE, Stoner MJ, Rewers A, McManemy JK, et al. Clinical trial of fluid infusion rates for pediatric diabetic ketoacidosis. N Engl J Med 2018;378:2275–2287. DOI: 10.1056/NEJMoa1716816.
  12. Van Zyl DG, Rheeder P, Delport E. Fluid management in diabetic-acidosis--Ringer's lactate versus normal saline: A randomized controlled trial. QJM 2012;105(4):337–343. DOI: 10.1093/qjmed/hcr226.
  13. Gupta P, Nasa P, Shahabdeen SM. Effectiveness of balanced electrolyte solution vs normal saline in the resuscitation of adult patients with diabetic ketoacidosis: An updated systematic review and meta-analysis. Indian J Crit Care Med 2025;29(1):65–74.
  14. Honore PM, Mugisha A, Kugener L, Redant S, Attou R, Gallerani A, et al. The causal link between hyperchloremia and acute kidney injury is yet to be conclusively established: We are not sure. Crit Care 2020; 24:271. DOI: 10.1186/s13054-020-02966-8.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.