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Reduce rate of insulin infusion to 0.05 units/kg/hr when glucose drops to <14 mmol/L. Crystalloid rather than colloid solutions are recommended for fluid resuscitation. 0.9% sodium chloride solution (‘normal saline’) is the fluid resuscitation of choice. Cautious fluid replacement in young adults.
22 maj 2020 · Principles of DKA Monitoring: • Basic metabolic panel, patient assessment of mental status, and insulin administration should occur q4h until anion gap has closed • Insulin dosing is based on q4h glucose from FS or venous blood • When possible, more frequent FS (q 2h) is recommended to monitor for hypoglycemia; Patients who are
Add Dextrose (D51⁄2NS or D5NS*) to IVF @ 150 – 250 mL/h to maintain serum glucose 150 – 200 mg/dL and continue insulin at same rate. Titrate insulin to a minimum 0.1 Units/kg/hr and glucose goal between 150 – 200 mg/dL until ketosis and anion gap resolves. If patient can tolerate PO, encourage consistent carbohydrate diet.
6 sie 2021 · A set of electrolytes ~6 hours after stopping the drip is a reasonable idea to make sure that the anion gap is remaining closed (if there is any doubt about this clinically). management of recurrent DKA. Causes of recurrent DKA (anion gap re-opens after stopping drip) Insulin infusion was stopped despite not meeting all five of the criteria above.
UNIVERSITY OF WASHINGTON SUBCUTANEOUS INSULIN DKA PROTOCOL To use this protocol, patient needs to meet the diagnosis for DKA and NOT have ANY of the following: (If critically ill→ UW IV Insulin Infusion Protocol) 1. Blood pH <7.0 2. Serum bicarbonate ≤ 10 mEq/L 3. Intubated 4. MAP < 65 after 1-2L IV fluids 5. K < 3.0 mEq/L 6.
BOX 2: INTRAVENOUS FLUID MANAGEMENT (Saline regime) CAUTION: Slower in young people aged 18-25 years, elderly, pregnant, heart or renal failure. BOX 3: INTRAVENOUS FLUID MANAGEMENT (Dextrose regime) Once CBG<14 mmol/L. 0.9% sodium chloride 1 litre (no KCl) Over 1st hour. Give 10% Dextrose to run at 125 mls/hr AND.
insulin and advance diet OR if unable to advance diet, change DKA insulin drip to ICU insulin Drip Order Set for Target Blood Glucose 140 - 180. • Notify prescriber if glucose is LESS THAN 100 mg/dL for two consecutive times and anion gap is GREATER THAN 12 for further insulin AND/OR Dextrose containing IV fluid rate adjustment. • Notify ...
