This iatrogenic complication can occur with excessive high-dose insulin therapy and bicarbonate therapy. It can be prevented by following current treatment protocols with frequent monitoring of potassium levels and appropriate replacement.
This iatrogenic complication can occur with excessive high-dose insulin therapy. It can be prevented by following current treatment protocols with frequent monitoring of plasma glucose and use of glucose-containing intravenous fluids.
arterial or venous thromboembolic events
Standard prophylactic low-dose heparin is certainly reasonable in these patients. Applying prophylactic treatment is based on clinical evaluation by the physician of risk factors for thromboembolic events. Currently no evidence exists for full anticoagulation.
cerebral oedema/brain injury
Assess Glasgow Coma Scale hourly to monitor for cerebral oedema.
pulmonary oedema/acute respiratory distress syndrome (ARDS)
Pulmonary oedema and acute respiratory distress syndrome (ARDS) are rare but significant complications of treatment for DKA and present with fluid overload and low oxygen saturations.
non-anion gap hyperchloraemic acidosis
This occurs due to urinary loss of ketoanions needed for bicarbonate regeneration, and also increased reabsorption of chloride secondary to intensive administration of chloride-containing fluids. This acidosis usually resolves and should not affect the treatment. It is more likely in pregnant women.
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