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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.
Diabetic ketoacidosis (DKA) is a frequent and potentially life-threatening complication of type 1 diabetes. Though preventable and despite advances in monitoring technologies, insulin therapeutics and insulin delivery systems, the rates of both community and hospital acquired DKA remain largely unchanged. Although mortality today is relatively
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
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.
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.
IV insulin infusion is recommended for critically ill patients with BG levels >180 mg/dL. The use of insulin infusion protocols standardizes care and improves clinical outcomes. Protocol should include strict BG monitoring and personalized insulin infusion rate titration to achieve and maintain BG targets.
