Safety and efficacy of an algorithm-based protocol in the management of diabetic ketoacidosis.
| Autor: | Maghrabi AH; Department of Internal Medicine, Marshall University, Joan C. Edwards School of Medicine, 1249 15th Street, Huntington, West Virginia 25701. maghrabi@marshall.edu, Hamoudeh E, Hassan T, Gress T, Yaqub A, Saleem TF |
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| Jazyk: | angličtina |
| Zdroj: | Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists [Endocr Pract] 2012 Nov-Dec; Vol. 18 (6), pp. 842-6. |
| DOI: | 10.4158/EP12023.OR |
| Abstrakt: | Objective: To determine the efficacy of an algorithm-based protocol to manage diabetic ketoacidosis (DKA). Methods: Our study is a retrospective chart review of patients with DKA managed before and after implementation of an algorithm-based DKA protocol at a tertiary care hospital. Results: There were 88 patients managed 1 year prior (control group) and 70 patients managed one year after (study group) implementation of the algorithm-based DKA protocol. The DKA resolution time was significantly shorter (11.5 [8.1 to 17.1] hours versus 8.5 [5.8 to 12] hours; P = 0.008) and the hypoglycemic events were significantly less (P = 0.042) in the study group in comparison with the control group. There was no difference in the potassium abnormalities and rate of decline of glucose. A survey on a scale of 1 to 10 found the majority of physicians and nurses rated the protocol as safe (83%) and effective (96%). Fifty-four percent of the nurses, however, found the protocol difficult to follow. Conclusion: Our study showed that implementation of an algorithm-based protocol reduced the DKA resolution time and hypoglycemic events without compromising electrolyte imbalance, and was associated with improved clinical measures of DKA management. |
| Databáze: | MEDLINE |
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