How is pediatric ketoacidosis treated?

Treatment of DKA requires first and foremost fluid resuscitation with 0.9% saline, followed by replacement for 5%–10% dehydration, depending on severity, and maintenance with 0.45% saline, and early and adequate K replacement.

What is the initial treatment for diabetic ketoacidosis?

The initial priority in the treatment of diabetic ketoacidosis is the restoration of extra-cellular fluid volume through the intravenous administration of a normal saline (0.9 percent sodium chloride) solution.

How do you calculate fluid deficit in pediatrics DKA?

For most children, use 5% to 8% dehydration to calculate fluids. Neonatal DKA will require special consideration and larger volumes of fluid than those quoted may be required, usually 100-150 ml/kg/24 hours)….Hrly rate = 48 hr maintenance + deficit – resusc. fluid already given / 48.

>60kg 35 ml/kg/24 hrs

What’s the protocol for diabetic ketoacidosis?

Treatment usually involves: Fluid replacement. You’ll receive fluids — either by mouth or through a vein — until you’re rehydrated. The fluids will replace those you’ve lost through excessive urination, as well as help dilute the excess sugar in your blood.

What happens if diabetic ketoacidosis goes untreated?

High levels of ketones in the blood disrupt normal working of many parts of the body. The more ketones in the blood, the more ill a person with diabetic ketoacidosis will become. Left untreated, diabetic ketoacidosis can cause potentially fatal complications, such as severe dehydration, coma and swelling of the brain.

Why is potassium given in diabetic ketoacidosis?

After insulin treatment is initiated, potassium shifts intracellularly and serum levels decline. Replacement of potassium in intravenous fluids is the standard of care in treatment of DKA to prevent the potential consequences of hypokalemia including cardiac arrhythmias and respiratory failure.

How long does it take to resolve DKA?

Once you’re safely admitted to the hospital for DKA, recovery is usually complete in one to three days.

What is anion gap in diabetic ketoacidosis?

Anion Gap. In patients with diabetic ketoacidosis, the anion gap is elevated ([Na + K] – [Cl + HCO3] greater than 10 mEq/L in mild cases and greater than 12 mEq/L in moderate and severe cases).

How much insulin do you give for ketoacidosis?

A mix of 24 units of regular insulin in 60 mL of isotonic sodium chloride solution usually is infused at a rate of 15 mL/h (6 U/h) until the blood glucose level drops to less than 180 mg/dL; the rate of infusion then decreases to 5-7.5 mL/h (2-3 U/h) until the ketoacidotic state abates.

How do you check for diabetic ketoacidosis?

Upon arrival at the hospital, a doctor may perform a variety of tests to determine whether you’re suffering from diabetic ketoacidosis or another condition. These include a blood sugar test, a blood test of electrolytes and kidney function, and a blood test to look for acid in the blood.

How does DKA kill you?

With Diabetic Ketoacidosis (DKA) your blood becomes highly acidic from dehydration and excessive ketone production; it can kill you. Diabetic Ketoacidosis (DKA) is a condition in which the blood becomes highly acidic as a result of dehydration and excessive ketone (acid) production.

What type of insulin is used to treat diabetic ketoacidosis?

Subcutaneous insulin can be used for treatment of uncomplicated DKA. Bicarbonate therapy has not been shown to improve outcomes in persons with DKA, but is recommended by consensus guidelines for persons with a pH less than 6.9. DKA = diabetic ketoacidosis.

What can you do to prevent diabetic ketoacidosis?

Follow these steps to help prevent DKA: Drink lots of water or sugar -free, nonalcoholic beverages. Take your medicines as directed. Follow your meal plan closely. Keep up with your exercise program. Test your blood sugar regularly. Check for expired insulin. Don’t use your insulin dose if it has clumps.