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糖尿病酮症酸中毒治疗中平衡液148与0.9%生理盐水的对比:一项综述

Plasma-Lyte-148 Versus Normal Saline 0.9% in Diabetic Ketoacidosis Management: A Review.

作者信息

Othman Mutaz I, Nashwan Abdulqadir J, Alfayoumi Moayad, Khatib Mohamad, Abujaber Ahmad A

机构信息

Critical Care, Hamad Medical Corporation, Doha, QAT.

Pharmacy, Hamad Medical Corporation, Doha, QAT.

出版信息

Cureus. 2023 Jun 28;15(6):e41079. doi: 10.7759/cureus.41079. eCollection 2023 Jun.

Abstract

Diabetic ketoacidosis (DKA) is a critical complication of diabetes mellitus characterized by hyperglycemia, ketonemia, circulatory collapse, hypokalemia, and metabolic acidosis. The therapeutic management of DKA includes vigilant fluid resuscitation to address dehydration and electrolyte imbalances and restore hemodynamic stability. The choice of fluid, either isotonic saline or a balanced electrolyte solution like Plasma-Lyte 148 (PL), is pivotal in the clinical outcomes of DKA patients. Recent studies have compared the effectiveness of these fluid solutions in DKA management, focusing on different clinical outcomes such as the resolution of metabolic acidosis, electrolyte imbalances, the incidence of acute kidney injury, and length of hospital stay. This review examines the literature comparing isotonic saline and balanced electrolyte solutions for fluid resuscitation in DKA, analyzing the associated clinical outcomes. Through synthesizing research findings, this review aims to elucidate the efficacy and potential advantages of utilizing PL as an alternative to traditional isotonic saline for fluid resuscitation in treating DKA. This would further facilitate evidence-based decision-making among healthcare professionals and contribute to optimizing DKA management strategies. Understanding the intricacies and implications of fluid resuscitation is crucial, given its profound impact on patient outcomes in DKA management.

摘要

糖尿病酮症酸中毒(DKA)是糖尿病的一种严重并发症,其特征为高血糖、酮血症、循环衰竭、低钾血症和代谢性酸中毒。DKA的治疗管理包括积极的液体复苏,以纠正脱水和电解质失衡,并恢复血流动力学稳定性。选择液体,无论是等渗盐水还是像百特148(PL)这样的平衡电解质溶液,对DKA患者的临床结局至关重要。最近的研究比较了这些液体溶液在DKA治疗中的有效性,重点关注不同的临床结局,如代谢性酸中毒的缓解、电解质失衡、急性肾损伤的发生率和住院时间。这篇综述审视了比较等渗盐水和平衡电解质溶液用于DKA液体复苏的文献,分析相关的临床结局。通过综合研究结果,本综述旨在阐明在治疗DKA时,使用PL替代传统等渗盐水进行液体复苏的疗效和潜在优势。这将进一步促进医疗专业人员基于证据的决策,并有助于优化DKA管理策略。鉴于液体复苏对DKA管理中患者结局的深远影响,了解其复杂性和意义至关重要。

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