Portal de Periódicos da CAPES

Effect of Rehydration Fluid With 75 mmol/L of Sodium on Serum Sodium Concentration and Serum Osmolality in Young Patients With Diabetic Ketoacidosis

1994; Elsevier BV; Volume: 69; Issue: 12 Linguagem: Inglês

10.1016/s0025-6196(12)65766-8

1942-5546

Kristina I. Rother, W. Schwenk,

Neurological and metabolic disorders

To evaluate whether rehydration of young patients with diabetic ketoacidosis (DKA) by use of a solution that contained 75 mmol/L of sodium would be associated with a decline in serum sodium concentrations.We retrospectively studied 18 episodes of moderate to severe DKA (mean plasma bicarbonate concentration of 7.8 +/- 0.9 mmol/L) in 17 patients younger than 18 years of age who had been examined at the Mayo Clinic between 1986 and 1990.All patients had received an initial fluid bolus (about 20 mL/kg) of 0.9% saline or Ringer's lactate (or both), followed by rehydration with solutions that contained 75 mmol/L of sodium at rates of approximately 3,000 mL/m2 per day. Mean corrected and uncorrected serum sodium concentrations and effective serum osmolality (before and after administration of the fluid bolus and at 6 and 12 hours into treatment) were compared by use of the paired Student t test.After 12 hours of therapy, we found a significant increase in the mean uncorrected serum sodium level from 135.1 +/- 0.9 mmol/L to 138.1 +/- 0.7 mmol/L (P < 0.05), whereas the mean corrected serum sodium value declined slightly from 143.1 +/- 1.1 mmol/L to 140.4 +/- 0.7 mmol/L (statistically not significant). Serum osmolality based on uncorrected serum sodium concentrations decreased at a rate of 2.6 mmol/kg per hour during the first 6 hours of treatment and remained stable thereafter.In 18 episodes of DKA in young patients, rehydration with fluids that contained 75 mmol/L of sodium at rates of approximately 3,000 mL/m2 per day after administration of a fluid bolus of 0.9% saline or Ringer's lactate (or both) was not associated with a decline in the uncorrected serum sodium concentration.