Plasma volume expansion reveals hidden metabolic acidosis in patients with diabetic ketoacidosis.

ABSTRACT:

Background

Hyperchloremic metabolic acidosis that develops during the treatment of diabetic ketoacidosis is usually attributed to the chloride content of resuscitation fluids. We explored an alternative explanation, namely that fluid-induced plasma volume expansion alters the absolute differences in the concentrations of sodium and chloride (the Na-Cl gap) enough to affect the acid-base balance. We analyzed data from a prospective single-center cohort study of 14 patients treated for diabetic ketoacidosis. All patients received 1 L of 0.9% saline over 30 min on two consecutive days. Blood gases were sampled before and after the infusions.

Results

The initial plasma volume was estimated to be 25 ± 13% (mean ± SD) below normal on admission to the intensive care unit. At that t

SUBMITTER: Svensson R 

PROVIDER: S-EPMC9424448 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature