Modified Diabetic Ketoacidosis Treatment Protocol: Safe, Simple, and Easy to Apply

The optimal intravenous fluid (IVF) administration rate in the treatment of pediatric diabetic ketoacidosis (DKA) is controversial. Our aim is to investigate the efficacy of a modified fixed IVF calculation in pediatric DKA. All patients received rehydration fluid at a standard rate of 3000 mL/m²/24 h. The infusion rate remained constant and was not changed for dehydration severity, age, baseline blood glucose level, daily fluid deficit, or maintenance fluid requirement calculation.

Data from 252 patients diagnosed with DKA were recorded. Of them, 126 were treated with the modified IVF procedure and 126 with the International Society for Paediatric and Adolescent Diabetes IVF regimen. Acidosis recovery time was 9 (2-46) and 9 (2-34) hours, respectively ( P = .48). Treatment groups showed no statistically significant differences in treatment-related problems. The modified IVF protocol can be safely and efficiently utilized in the pediatric population, excluding those requiring initial intensive care unit management, without the need to calculate daily fluid deficit or maintenance fluid need.