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Hosp Pharm. 2018 Oct;53(5):326-330. doi: 10.1177/0018578718757517. Epub 2018 Feb 16.

Comparison of Plasma-Lyte A and Sodium Chloride 0.9% for Fluid Resuscitation of Patients With Diabetic Ketoacidosis.

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Department of Pharmacy, University of Maryland Medical Center, Baltimore, MD, USA.
Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Department of Pharmacy, Massachusetts General Hospital; Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA.


Purpose: The aim of this study was to compare Plasma-Lyte A (PL) and sodium chloride 0.9% (NS) in regard to time to resolution of diabetic ketoacidosis (DKA) when one fluid was used predominantly over the other for resuscitation. Methods: We performed a retrospective analysis of the records of patients treated for DKA at a large, academic medical center between July 1, 2013, and July 1, 2015. Patients were placed into the PL or NS group based on the predominant fluid they received during fluid resuscitation. Serum biochemistry variables were categorized as follows: initial, 2 to 4 hours, 4 to 6 hours, 6 to 12 hours, and 12 to 24 hours. The primary outcome was mean time to resolution of DKA. Results: Eighty-four patients were included in the study. The primary outcome of mean time to resolution of DKA was similar between the PL (19.74 hours) and NS (18.05 hours) groups (P = .5080). Patients treated with PL had a significantly greater rise in pH within the 4- to 6-hour and 6- to 12-hour periods. The chloride level was significantly higher and the anion gap was significantly lower for the NS group in the 6- to 12-hour period. Conclusion: These data suggest that the use of PL for fluid resuscitation in DKA may confer certain advantages over NS.


Plasma-Lyte A; diabetic ketoacidosis; normal saline

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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