Jahangir Ahmad, Jahangir Abdullah, Siddiqui Fasih Sami, Niazi Muhammad Rafay Khan, Yousaf Fahad, Muhammad Marwah, Sahra Syeda, Javed Aneeqa, Sharif Muhammad Ans, Iqbal Qasim Zafar, Krzyzak Michael
Medicine, Mayo Hospital, Lahore, PAK.
Medicine, Staten Island University Hospital, New York City, USA.
Cureus. 2022 Jan 17;14(1):e21324. doi: 10.7759/cureus.21324. eCollection 2022 Jan.
Traditionally, normal saline solution (NSS) has been the fluid of choice in diabetic ketoacidosis (DKA) patients, but the NSS is an acidic fluid and may lead to the delayed resolution of DKA. A systemic review search was conducted on PubMed, Embase, and Central Cochrane Registry to compare the efficacy of low chloride solutions with normal saline solution in DKA resolution. Randomized clinical trials with normal saline as a control arm and low chloride solutions as an intervention arm were included. Four studies were included in the analysis. The investigated outcomes, including time to resolution for DKA and duration of insulin infusion, varied depending on the endpoint were reported in the studies. Overall, balanced solutions were generally associated with faster correction of pH. The time to reach overall DKA endpoints was comparable in both groups. We concluded that crystalloid solutions may be used as an initial resuscitation fluid in the DKA population and may lead to earlier resolution of acidosis. More clinical trial data is required to reach statistical significance for the hypothesis.
传统上，生理盐水（NSS）一直是糖尿病酮症酸中毒（DKA）患者的首选补液，但NSS是一种酸性液体，可能会导致DKA缓解延迟。我们在PubMed、Embase和Cochrane中央注册库进行了一项系统综述检索，以比较低氯溶液与生理盐水在DKA缓解方面的疗效。纳入了以生理盐水为对照臂、低氯溶液为干预臂的随机临床试验。分析中纳入了四项研究。研究报告的研究结果，包括DKA缓解时间和胰岛素输注持续时间，因终点不同而有所差异。总体而言，平衡溶液通常与更快的pH值纠正相关。两组达到总体DKA终点的时间相当。我们得出结论，晶体溶液可作为DKA人群的初始复苏液体，可能会使酸中毒更早得到缓解。需要更多的临床试验数据才能使该假设具有统计学意义。
