Ebook Pocket guide to critical care pharmacotherapy (2nd edition): Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Pocket guide to critical care pharmacotherapy (2nd edition): Part 2
Ebook Pocket guide to critical care pharmacotherapy (2nd edition): Part 2
Chapter 6EndocrinologyTable 6.1 Management of diabetic ketoacidosis and hyperosmolar hyperglycemic state•Identify precipitating factorsInfection, acut Ebook Pocket guide to critical care pharmacotherapy (2nd edition): Part 2te coronary syndrome, cerebrovascular accidents, trauma, noncompliance with insulin pharmacotherapy, new-onset diabetes mellitus. and medications (e.g., corticosteroids and sympathomimetics)•Prepare a comprehensive flow sheet with vitals, laboratory data, fluid type and rates, insulin rates, and oth Ebook Pocket guide to critical care pharmacotherapy (2nd edition): Part 2er treatments•Correct fluid abnormalitieso Upon presentation: normal saline infused at 15-20 mDkg/h (providing 1-1.5 L in the first hour), then 4-14 mEbook Pocket guide to critical care pharmacotherapy (2nd edition): Part 2
L'kg/h for most patients■Use clinical variables (e.g.. blood pressure, heart rate, skin temperature) to target euvolemia: urine output may not be reliChapter 6EndocrinologyTable 6.1 Management of diabetic ketoacidosis and hyperosmolar hyperglycemic state•Identify precipitating factorsInfection, acut Ebook Pocket guide to critical care pharmacotherapy (2nd edition): Part 2replacement (i.e..0.45 % saline). Lactated Ringer’s solution may prolong ketoacid production by promoting alkalinization■Serum sodium may rise with insulin and isotonic saline fluid administration: estimate the corrected serum sodium concentration at presentation:□ Add 1.6 mEq/L to the measured seru Ebook Pocket guide to critical care pharmacotherapy (2nd edition): Part 2m sodium for every 100 mg/dL rise in blood glucose>200 mg/dLWhen blood glucose falls to <200 mg/dL. switch to D5W. D5W/1/2 NS. or D5W/NS depending onEbook Pocket guide to critical care pharmacotherapy (2nd edition): Part 2
plasma sodium concentration(continued)I Tì-on886 EndocrinologyTable 6.1 (continued)•Regular insulin° Do not initiate insulin therapy if the sei unipotChapter 6EndocrinologyTable 6.1 Management of diabetic ketoacidosis and hyperosmolar hyperglycemic state•Identify precipitating factorsInfection, acut Ebook Pocket guide to critical care pharmacotherapy (2nd edition): Part 2al saline (new tubing should be primed with 20 mL of the infusion)° Use an ideal body weight to dose insulin in obese patients° Bolus with 0.1 units/kg IV. then 0.05-0.1 units/kg/h continuous IV infusion■Consider withholding the insulin bolus in the setting of shock until resuscitation is underway: Ebook Pocket guide to critical care pharmacotherapy (2nd edition): Part 2rapid lowering of blood glucose can precipitate worsening of the hypovolemia state■If blood glucose does not decrease by at least 10 % in the first hoEbook Pocket guide to critical care pharmacotherapy (2nd edition): Part 2
ur, administer 0.14 units/kg regular insulin bolus then adjust the continuous infusion° Goal is to reduce blood glucose by 50-150 mg/dL/h. Use an instChapter 6EndocrinologyTable 6.1 Management of diabetic ketoacidosis and hyperosmolar hyperglycemic state•Identify precipitating factorsInfection, acut Ebook Pocket guide to critical care pharmacotherapy (2nd edition): Part 2aintain blood glucose between 150 and 200 mg/dLo Monitor blood glucose every hour. Once blood glucose is within the range of 150-200 mg/dL on three consecutive measurements and the anion gap closes, monitor blood glucose every 2 h■If hypoglycemia develops in the setting of continued ketoacidosis, lo Ebook Pocket guide to critical care pharmacotherapy (2nd edition): Part 2wer the insulin infusion and administer glucose infusions to maintain euglycemia. Do not stop the insulin infusion° Monitor anion gap as often as neceEbook Pocket guide to critical care pharmacotherapy (2nd edition): Part 2
ssary (e.g.. every 4 11)•Transition to long acting insulin (e.g.. insulin glargine) once ketoacidosis has resolved, blood glucose <200 mg/dL, and the Chapter 6EndocrinologyTable 6.1 Management of diabetic ketoacidosis and hyperosmolar hyperglycemic state•Identify precipitating factorsInfection, acut Ebook Pocket guide to critical care pharmacotherapy (2nd edition): Part 2 then daily at the same time each dayChapter 6EndocrinologyTable 6.1 Management of diabetic ketoacidosis and hyperosmolar hyperglycemic state•Identify precipitating factorsInfection, acutGọi ngay
Chat zalo
Facebook