How is dehydration treated in patients with DKA?

In the treatment of dehydration in patients with Diabetic Ketoacidosis (DKA), the administration of IV Normal Saline (NS) is the most appropriate approach. DKA often leads to significant fluid loss due to hyperglycemia-induced osmotic diuresis and can result in severe dehydration.

The use of IV Normal Saline serves multiple purposes. It helps to replenish the depleted intravascular volume, correct electrolyte imbalances, and provide necessary hydration to the tissues. Normal Saline is isotonic, meaning it has a similar osmolarity to blood plasma. This characteristic allows for efficient volume replacement without causing fluid shifts that could exacerbate the situation.

While IV insulin is crucial in addressing the underlying metabolic changes in DKA by helping to lower blood glucose and suppress ketone production, it does not address the immediate need for fluid replacement. IV dextrose, while useful in managing hypoglycemia later in treatment, is not appropriate for initial rehydration. Oral rehydration solutions, while sometimes effective in mild dehydration, are inadequate in the context of DKA where patients may be unable to tolerate oral intake or may have ongoing fluid deficits needing rapid correction. Thus, IV Normal Saline is the cornerstone for treating dehydration in DKA patients