Will give NS at 15 to 20 mL/kg lean body weight per hour for the first 2hrs to tx hypovolemia. That is about 1L/hr for the average person and 2 Liters over 2 hrs.
NB: The initial resuscitation fluids is always NS.
Will then calc. corrected Na to determine if to use NS or ½ NS as ongoing IVF.
If corrected Na is high or normal, then cont with 1/2 NS@250-500 cc/hr
If the corrected Na conc is low, cont with NS @250-500cc.
When serum glucose reaches 200 mg/dL and DKA is not yet resolved, we will change the IVF to D5 + ½ NS at 150-250cc/hr.
Keep IVF to a max of < 50 ml/kg in the first four hours.
The “corrected” [Na] is approximated by adding 2.0 mEq/L to the plasma Na conc for each 100 mg/100 mL increase above normal in glucose conc.
Related Article: Diabetic Ketoacidosis (DKA) Treatment