Start with a free trial account for free content every month. Already a subscriber? Sign in.

Paper Chase 2 – Fluid Volume in Pediatric DKA

Sanjay Arora, MD and Mike Menchine, MD
00:00
04:14
Sign in or subscribe to listen

No me gusta!

The flash player was unable to start. If you have a flash blocker then try unblocking the flash content - it should be visible below.

Nurses Edition Commentary

Mizuho Spangler, DO, Lisa Chavez, RN, and Kathy Garvin, RN
00:00
00:28

No me gusta!

The flash player was unable to start. If you have a flash blocker then try unblocking the flash content - it should be visible below.

EM:RAP 2016 August Written Summary 819 KB - PDF

Two different initial fluid volumes (10 mL/kg vs 20 mL/kg) were compared as the initial fluid bolus in pediatric patients with DKA.The 20 mL/kg group had a faster adjusted time to metabolic recovery with no increase in adverse events.

To view chapter written summaries, you need to subscribe.

Sign up today for full access to all episodes.

KB -

I am a little surpised that increasing the volume of NS resulted in improved metabolic derangement. The ICU attendings where I work encourage the use of LR, because there is almost always a hyperchloremic acidosis which occurs when using NS. I now almost exclusively use LR because I have found this to be true. Maybe the acidosis improved in these children secondary to profound dehydration? Thoughts?

Mike J., M.D. -

Ok, realize that these kids, (and adults) did not become volume deplete and develop DKA in hours, why do we feel the need to fix them in hours. Large datasets of patients with volume depletion (the FEAST study) have demonstrated that overaggressive bolus resuscitation is associated with poor outcome. I don't think a 50 patient study is going to change my management of these patients, adult or children.

They didn't get sick in hours, we don't need to fix them in hours.

To join the conversation, you need to subscribe.

Sign up today for full access to all episodes and to join the conversation.

To download files, you need to subscribe.

Sign up today for full access to all episodes.
Can You Pick Your Friend's Nose? Full episode audio for MD edition 260:32 min - 363 MB - M4AEM:RAP 2016 August German Edition Deutsche 78:23 min - 108 MB - MP3EM:RAP 2016 August French Edition Français 35:54 min - 49 MB - MP3EM:RAP 2016 August Aussie Edition Australian 29:08 min - 40 MB - MP3EM:RAP 2016 August Canadian Edition Canadian 26:55 min - 37 MB - MP3EM:RAP 2016 August Spanish Edition Español 73:36 min - 101 MB - MP3EM:RAP 2016 August Board Review Answers 285 KB - PDFEM:RAP 2016 August Board Review Questions 246 KB - PDFEM:RAP 2016 August Written Summary 819 KB - PDFEM:RAP 2016 August Individual MP3 Files 308 MB - ZIPEM:RAP 2016 August El Resumen Escrito en Español 2 MB - PDF

To earn CME for this chapter, you need to subscribe.

Sign up today for full access to all episodes and earn CME.

0.25 Free AMA PRA Category 1 Credits™ certified by Hippo Education

  1. Complete Quiz
  2. Complete Evaluation
  3. Print Certificate

4.25 AMA PRA Category 1 Credits™ certified by Hippo Education

  1. Complete Quiz
  2. Complete Evaluation
  3. Print Certificate