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6 sie 2021 · Continue insulin infusion per protocol, until ALL the following criteria are met: Resolution of ketoacidosis (anion gap <10-12 mM, in the absence of renal failure). Bicarbonate >18 mM.
This guidance also addresses the new problem of DKA and particularly euglycaemic DKA in those treated with SGLT-2 inhibitors. It also for the first time considers ketosis prone type 2 diabetes and the complex issue of the management of DKA in people with end stage renal failure or on dialysis.
Patients with severe DKA (plasma glucose >250 mg/dL, arterial pH <7.00, serum bicarbonate <10 mEq/L), hypotension, anasarca (severe generalized edema), or associated severe critical illness should be managed with intravenous regular insulin in the ICU using the regimen described above.
27 kwi 2023 · Subcutaneous fast-acting insulin analogues, alone or in combination with long-acting insulin, versus intravenous regular insulin infusion in patients with diabetic ketoacidosis: protocol for an updated systematic review and meta-analysis of randomised trials
21 paź 2021 · Critically Ill diabetic ketoacidosis is usually a bit of a misnomer. Despite numbers that look HORRIBLE–most of these patients are not particularly at risk of death. In fact, for almost all critical DKA patients, we can have them home or on a floor bed in about ~16 hours.
8 sie 2022 · Kaiser Permanente SRO has had a continuous insulin infusion protocol since 2014 for mild-to-moderate DKA on Med Surg/observation, whereas SRF has managed these patients in the ICU. This study was approved by the KPNC Institutional Review Board with a waiver of informed consent.
PROCEDURE: The DKA Critical Care Adult powerplan is initiated by the physician/AHP. Ensure patient has 2 large bore IVs or central access. measured using i-STAT until glucose is less than 500. Administer IV fluid bolus and maintenance as ordered. Access the DKA calculator on the EMMC homepage and enter required information on the DKA.
