Effect of Fluid Replacement Therapy on Complication and Recovery Time of Diabetic Ketoacidosis: Comparison of Two Protocols

OBJECTIVES: To evaluate the effect of two simultaneous protocols in reducing recovery time and assessment of adverse effects of different fluid replacement therapy in management of diabetic ketoacidosis. MATERIALS AND METHODS: In this randomized clinical trial study, two standard protocols were chosen to evaluate recovery time and incidence of DKA complications. RESULTS: 18 subjects who had severe diabetic ketoacidosis were included in our analysis. In the course of treatment, hypokalemia happened in 5 cases in protocol 1 and 4 cases in protocol 2. Hypernatremia occurred in 2 cases of protocol 1 and 4 cases in protocol 2. Hyponatremia occured in 4 cases of protocol 1 and 2 cases in protocol 2. The mean recovery time of acidosis in protocol 1 was 21 ± 5.9 (mean ± SD) hours and 23 ± 10.9 hours in protocol 2. None of them had any signs and symptoms of cerebral edema or mental status deterioration in the course of treatment. CONCLUSION: According to our study, different volume deficit calculated as a base for dehydration which was replaced in different times and in a similar clinical setting, had not added any risk of complications during the treatment. Also no significant differences were found in recovery time related to the different fluid replacement protocols. We also found that complication of therapy increases with the severity of diabetic ketoacidosis.