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September 2025
This algorithm summarizes our suggested approach to the management of DKA in adults.
DKA diagnostic criteria: Hyperglycemia (eg, for new-onset diabetes, glucose ≥200 mg/dL [11.1 mmol/L]), venous pH <7.3, serum bicarbonate <18 mEq/L, and at least moderate ketonuria (≥2+) or ketonemia (BOHB ≥3 mmol/L). Normal laboratory values vary; check local laboratory reference ranges for all electrolytes.
For monovalent ions (eg, K+, HCO3–), 1 mEq/L = 1 mmol/L.BOHB: beta-hydroxybutyrate; BUN: blood urea nitrogen; DKA: diabetic ketoacidosis; HCO3: bicarbonate; IV: intravenous; K+: potassium; KCl: potassium chloride; Na+: sodium; NaCl: sodium chloride; NaHCO3: sodium bicarbonate; STAT: intervention should be performed emergently; SUBQ: subcutaneous.
* After history and physical examination, obtain capillary glucose and serum or urine ketones. Begin 1 L of 0.9% NaCl (or buffered crystalloid [eg, Lactated Ringer]) over 1 hour, and draw arterial blood gas (or mixed venous blood gas), complete blood count with differential, urinalysis, serum glucose, BUN, electrolytes, chemistry profile, and creatinine levels STAT. Obtain electrocardiogram and, if needed, chest radiograph and specimens for bacterial cultures.
¶ Serum Na+ should be "corrected" for hyperglycemia (for each 100 mg/dL increase in glucose above 100 mg/dL, add 2 mEq to sodium value for corrected serum sodium value).
Δ As an alternative to fixed-rate insulin infusion, a variable-rate infusion may be administered based on a nurse-driven protocol.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
