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Guidelines recommend normal saline for fluid resuscitation in patients with diabetic ketoacidosis (DKA). However, the excess chloride content of normal saline might delay correction of acidosis, whereas balanced electrolyte solutions (e.g., lactated Ringer's solution) potentially could facilitate more-rapid resolution. In a meta-analysis of three randomized trials (2 were unblinded) that involved 316 patients, researchers compared normal saline and balanced solutions in adults hospitalized with DKA. All patients received, on average, similar amounts of intravenous fluid.
Patients who received balanced solutions had shorter time to DKA resolution, by 3 hours. This result was statistically significant by one calculation method (P=0.01) and not…