Pemberian Ringer Lactate Vs Normal Saline Untuk Tatalaksana Ketoasidosis Diabetik : Manakah Yang Lebih Baik ?

Abstract

Diabetic ketoacidosis (DKA) is a life threatening diabetic condition characterized by metabolic and homeostasis disturbance. In addition to timely identification of the precipitating cause, the first step in acute management of these disorder includes aggressive administration of intravenous (IV) fluid. Two types of IV fluids commonly used for general fluid replacement in hospitalized patients, Balanced Electrolyte Solutions (BES) such as Ringer Lactate (RL) and Normal Saline 0,9% (NS). Current guideline suggest the use of NS as the preferred resuscitation fluid. However, the excess chloride content of NS might cause hyperchloremic metabolic. BES such as Ringer Lactate (RL) solution have been proposed as an alternative due to a lower propensity to cause this complication and potentially could facilitate more-rapid resolution. Evidence regarding the use of BES in DKA remains limited. To determine if the use of RL in fluid resuscitation leads to faster resolution of DKA compared to NS. This type of research is a literature review. The study involves a comprehensive search of literature from PubMed, Google Scholar, EBSCO, and Science Direct of clinical trials addressing the use of BES vs NS in fluid resuscitation in DKA. The time to resolution of DKA was examined as the primary endpoint. The literature search included 19 studies that were screened individually. A total of 24 studies were identified but 5 studies were excluded due to irrelevance in the outcome of interest and target population. These review suggest that the use of RL for fluid resuscitation in DKA was shown to be superior to 0,9% NS in terms of alleviating DKA quicker