Podcast 667: Lactated Ringers for DKA

Contributor: Aaron Lessen, MD

Educational Pearls:

• Recent study looked at whether lactated ringers might be a better choice for fluid resuscitation in patients with DKA compared to normal saline
• Normal saline can cause a hyperchloremic metabolic acidosis
• Time to resolution of acidosis was 4 hours less with lactated ringers compared to normal saline
• Time on an insulin drip decreased by about 4 hours with lactated ringers compared to normal saline
• LR might be a better choice for fluid resuscitation in patients with DKA

References

Self WH, Evans CS, Jenkins CA, et al. Clinical Effects of Balanced Crystalloids vs Saline in Adults With Diabetic Ketoacidosis: A Subgroup Analysis of Cluster Randomized Clinical Trials. JAMA Netw Open. 2020;3(11):e2024596. doi:10.1001/jamanetworkopen.2020.24596

Summarized by John Spartz, MS3 | Edited by Erik Verzemnieks, MD