Related Experiment Video
Updated: Nov 17, 2025

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Implementation of an Intravenous Fluid Titration Algorithm to Treat Pediatric Diabetic Ketoacidosis
Christopher Babbitt1, Marc Dadios2, Ariya Chau3
1Division of Pediatric Critical Care, Miller Children's and Women's Hospital Long Beach, Long Beach, California, United States.
Abstract:
Diabetic ketoacidosis (DKA) is a common cause of admission to the pediatric intensive care unit and many centers utilize the "two-bag system" to treat DKA. We developed an intravenous fluid (IVF) titration algorithm to standardize adjustments of the two bags. A retrospective cohort study was performed comparing 155 patients treated before and 175 patients treated after implementation of the IVF titration algorithm. Postimplementation patients reached the blood glucose target zone faster and had a higher probability of remaining at goal while on insulin infusion. There was no significant difference in incidence of cerebral edema or hypoglycemia between study groups. Overall IVF titration algorithm compliance was 95%. Implementation of an IVF titration algorithm is safe and effective when treating DKA in children.
Related Concept Videos
Drug Dosing: Infants and Children
Acute Kidney Injury V: Interprofessional Care
Pharmacokinetics in Pediatric Patients: Drug Excretion
Acute Kidney Injury VI: Nursing Management
Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

