Pediatric clinics of North America
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Pediatr. Clin. North Am. · Apr 1990
ReviewConcepts of fluid therapy in diabetic ketoacidosis and hyperosmolar hyperglycemic nonketotic coma.
Despite many advances in the overall treatment of type I diabetes mellitus during the last few years, no major advance has been made in decreasing the mortality rate of diabetic ketoacidosis or hyperosmolar hyperglycemic nonketotic coma. A major concern in both of these disease states is the development of cerebral edema during treatment. The guiding principles of therapy in both disease states are rehydration, electrolyte replacement, insulin therapy, and treatment of any underlying illnesses. ⋯ Fluid and electrolyte deficits should be calculated and replaced during 48 hours. Low-dose insulin therapy is employed for treatment of hyperglycemia. Neurologic function should be carefully monitored and mannitol administered if a change in neurologic function occurs.
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Pediatr. Clin. North Am. · Apr 1990
Review Case ReportsEstimation of parenteral fluid requirements.
This article reviews the normal physiologic losses of water and electrolytes from the body, the source of the loss, and the increased body loss of water associated with fever. The three different methods for estimating replacement of water and electrolyte losses are described in this review.