Study of plasma osmolarity during the treatment of diabetic ketoacidoses

Analysis of 610 cases of diabetic ketoacidosis, of which 210 severe cases, showed that before beginning the treatment 6.2% of the patients presented hypoosmolarity, 41.4% normoosmolarity (dysosmolarity) and 52.2% hyperosmolarity. In predominantly hypernatremic hyperosmolarity (5.9% of cases) the authors recommend weak alkaline hypotonic electrolytic solutions (222 mOsm/l). 5% glucose solution and insulin in small doses less than 5 U/h; in predominantly hyperglycemic hyperosmolarity, weak alkaline isotonic electrolytic solutions (309 mOsm/l) and insulin in medium doses (6--8 U/h); in exclusively hyperglycemic hyperosmolarity, hypertonic electrolytic solutions (395 mOsm/l) associated with sufficient insulin dosis (8--12 U/h).