Evaluation and Management of the Critically Ill Adult With Diabetic Ketoacidosis.
diabetes
diabetic ketoacidosis
endocrine
hyperglycemia
ketones
metabolic acidosis
Journal
The Journal of emergency medicine
ISSN: 0736-4679
Titre abrégé: J Emerg Med
Pays: United States
ID NLM: 8412174
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
19
02
2020
revised:
24
05
2020
accepted:
11
06
2020
pubmed:
9
8
2020
medline:
24
6
2021
entrez:
9
8
2020
Statut:
ppublish
Résumé
Diabetic ketoacidosis (DKA) is a hyperglycemic emergency that presents commonly to the emergency department. Severe DKA has the potential for significant morbidity and mortality if not recognized early and treated appropriately. It is incumbent on the emergency clinician to be vigilant in the management of these critically ill patients. This narrative review evaluates the emergency medicine management of the adult patient with severe DKA. DKA is a condition found most commonly in patients with insulin-dependent diabetes, often due to nonadherence with diabetic medications or an inciting event, such as infection or ischemia. The severity of DKA is classified based on the level of acidosis present rather than absolute glucose level. The management of severe DKA involves assessing and treating the inciting event, fluid hydration, insulin, and potassium repletion. Close monitoring is necessary to prevent the complications that can occur. DKA is a medical condition that has the potential for significant morbidity and mortality if not recognized and managed appropriately.
Sections du résumé
BACKGROUND
BACKGROUND
Diabetic ketoacidosis (DKA) is a hyperglycemic emergency that presents commonly to the emergency department. Severe DKA has the potential for significant morbidity and mortality if not recognized early and treated appropriately. It is incumbent on the emergency clinician to be vigilant in the management of these critically ill patients.
OBJECTIVE
OBJECTIVE
This narrative review evaluates the emergency medicine management of the adult patient with severe DKA.
DISCUSSION
CONCLUSIONS
DKA is a condition found most commonly in patients with insulin-dependent diabetes, often due to nonadherence with diabetic medications or an inciting event, such as infection or ischemia. The severity of DKA is classified based on the level of acidosis present rather than absolute glucose level. The management of severe DKA involves assessing and treating the inciting event, fluid hydration, insulin, and potassium repletion. Close monitoring is necessary to prevent the complications that can occur.
CONCLUSIONS
CONCLUSIONS
DKA is a medical condition that has the potential for significant morbidity and mortality if not recognized and managed appropriately.
Identifiants
pubmed: 32763063
pii: S0736-4679(20)30662-4
doi: 10.1016/j.jemermed.2020.06.059
pii:
doi:
Substances chimiques
Insulin
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
371-383Informations de copyright
Published by Elsevier Inc.