Evaluation of the treatment of diabetic ketoacidosis in the medical intensive care unit

• DOI: 10.2146/sp150028
• Publication Date: 2015-11-18T11:18:00Z
• Authors: Nicholas Fusco; Jeffrey Gonzales; Siu Yan Amy Yeung
• Keywords: Diabetic ketoacidosis; Bolus (digestion); Clinical endpoint

To determine if treatment of DKA in a sample adult medical intensive care unit (MICU) patients was consistent with the 2006 ADA Hyperglycemic Crises Adult Patients Diabetes Clinical Guidelines.Medical records were reviewed for all admitted to MICU diagnosis between July 1, 2007 and June 30, 2010. The primary composite endpoint assessed fluid resuscitation (total mL/kg) at 24 hours, insulin bolus dose, continuous infusion (units/kg or units/kg/hour) whether clinical guidelines followed. Secondary outcome measures resolution, ICU length stay, frequency rebound within 48 hypoglycemia, time transition subcutaneous insulin.A total 60 met inclusion criteria. For treated compliance compared those that not, volume IV infused during first hours (4.88 ± 0.77 mL/kg/hour 2.74 1.08 mL/kg/hour), mean dose (0.13 0.04 units/kg 0.06 units/kg) initial rate infusions (0.11 0.02 units/kg/hour 0.08 0.03 significantly different (p <0.001). Treatment 12 (20%) followed guidelines, resolution stay trended toward shorter duration these patients.Compliance low MICU. Institutional management diabetic ketoacidosis should be investigated as strategy improve national guidelines.