علاج الحماض الكيتوني السكري: البروتوكول السريري للخط الأول

References

• Commence 0.9% sodium chloride solution (use a large bore cannula) via an infusion pump
• Start a continuous FRIII via an infusion pump. This is made of 50 units of human soluble insulin (Actrapid®, Humulin S®) made up to 50 ml with 0.9% sodium chloride solution.
• Thus it is recommended that 0.9% sodium chloride solution with potassium 40 mmol/L (ready-mixed) is prescribed as long as the serum potassium level is below 5.5 mmol/L and the person is passing urine.
• Reduction of the blood ketone concentration by 0.5 mmol/L/hour
• Increase the venous bicarbonate by 3.0 mmol/L/hour
• Reduce capillary blood glucose by 3.0 mmol/L/hour
• Maintain potassium between 4.0 and 5.5 mmol/L
• Resolution of DKA is defined as ketones less than 0.6 mmol/L and venous pH over 7.3
• By 24 hours the ketonaemia and acidosis should have resolved in most people