How do you make insulin infusion for DKA?

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.

Which infusion is best for a diabetic patient?

For decades, 0.9% saline has been the fluid of choice for diabetic ketoacidosis, and its use continues to be advocated in modern textbooks on diabetes. Early studies on diabetic ketoacidosis in the 1970s used 0.9% saline,5 and this approach was reinforced a decade later.

How do you calculate fluid deficit in DKA for children?

Add calculated maintenance (for 48 hrs) and estimated deficit, subtract the amount already given as resuscitation fluid, and give the total volume evenly over the next 48 hours. i.e. Hourly rate = 48 hr maintenance + deficit – resuscitation fluid already given / 48.

How much fluid do you give in HHS?

According to American Diabetes Association guidelines, fluid resuscitation with 0.9% saline at the rate of 15-20 mL/kg/h or greater is indicated to expand the extracellular volume quickly in the first hour.

How is insulin infusion calculated?

Determination of intravenous infusion rate is as follows: units of insulin per hour = (blood glucose – 60) × 0.02.

How do you give d50 and insulin for hyperkalemia?

Guidelines from the American Heart Association recommend treating adults who have severe cardiotoxicity or cardiac arrest due to hyperkalemia with an infusion of 25 grams of 50% dextrose mixed with 10 units of regular insulin infused intravenously over 15 to 30 minutes.

How is diabetic coma treated?

Diabetic coma requires emergency medical treatment….High blood sugar

  1. Intravenous fluids to restore water to your tissues.
  2. Potassium, sodium or phosphate supplements to help your cells function correctly.
  3. Insulin to help your tissues absorb the glucose in your blood.
  4. Treatment for any underlying infections.

How rapidly is fluid volume replaced in DKA?

Fluid loss averages approximately 6–9 L in DKA. The goal is to replace the total volume loss within 24–36 hours with 50% of resuscitation fluid being administered during the first 8–12 hours.

Which IV fluid is to be avoided in diabetic patients?

In 1978, Thomas and Alberti provided limited evidence that the use of Hartmann’s solution—which is similar in composition to lactated Ringer’s solution (LR)—causes transient elevation of blood glucose levels in diabetic patients and cautioned against the use of any lactate-containing intravenous (IV) fluid replacement …

Can we give ns to diabetic patient?

In fact, according to 2012 National Health Services (NHS) diabetes guideline for the perioperative management of the adult patient with diabetes, Hartmann’s solution is used in preference to 0.9% saline. Excess use of normal saline could yield complications such as hyperglycemia and metabolic acidosis.