In the context of DKA treatment, what is the first fluid to administer?

In the treatment of Diabetic Ketoacidosis (DKA), the first fluid to be administered is normal saline. This choice is critical because normal saline (0.9% sodium chloride) is isotonic, which helps to rapidly restore intravascular volume and improve tissue perfusion. In patients with DKA, dehydration and electrolyte imbalances are common due to osmotic diuresis caused by hyperglycemia. Administering normal saline helps in rehydrating the patient effectively while simultaneously providing sodium, which can be beneficial in managing electrolyte levels.

Once the initial fluid therapy is underway and the patient's status is stabilized, further adjustments can be made regarding the fluid type, including consideration for electrolyte replenishment and the introduction of dextrose when blood glucose levels drop significantly. Normal saline is specifically preferred in the acute phase to address the urgent needs of fluid resuscitation without exerting too much pressure on the remaining electrolytic balance that might be affected by hypotonic or more complex solutions.