Optimizing the treatment of diabetic ketoacidosis

Neymark M.I.

Altai State Medical University;
Barnaul Clinical Hospital «Russian Railways-Medicine»

ORCID: 0000-0001-9135-6392

Kloster E.A.

Barnaul Clinical Hospital «Russian Railways-Medicine»

ORCID: 0000-0002-2221-5753

Bulganin A.A.

Altai State Medical University;
Barnaul Clinical Hospital «Russian Railways-Medicine»

ORCID: 0000-0002-2057-0735

Optimizing the treatment of diabetic ketoacidosis

Authors:

Neymark M.I., Kloster E.A., Bulganin A.A.

More about the authors

Journal: Russian Journal of Anesthesiology and Reanimatology. 2024;(2): 67‑77

DOI: 10.17116/anaesthesiology202402167

Downloaded: 9

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Neymark MI, Kloster EA, Bulganin AA. Optimizing the treatment of diabetic ketoacidosis. Russian Journal of Anesthesiology and Reanimatology. 2024;(2):67‑77. (In Russ.)
https://doi.org/10.17116/anaesthesiology202402167

Close metadata

OBJECTIVE

To justify advisability of meglumine sodium succinate (Reamberin) in infusion therapy of diabetic ketoacidosis.

MATERIAL AND METHODS

A prospective study included 100 patients with diabetes mellitus complicated by diabetic ketoacidosis. Patients were divided into 2 groups depending on infusion therapy: group 1 — saline solution, group 2 — meglumine sodium succinate (Reamberin) 10 ml/kg daily. We analyzed control indicators of treatment, speed of achieving these indicators and acid-base state.

RESULTS

The best results were achieved in the second group. Median period of diabetic ketoacidosis was 42 and 34 hours, respectively. Accordingly, time of intravenous insulin infusion was 44 and 34 hours, respectively. ICU-stay was 52 and 46 hours, respectively. Dynamics of acid-base state indicators was slower in the first group compared to normalization rate in the second group.

CONCLUSION

Meglumine sodium succinate (Reamberin) in intensive therapy of diabetic ketoacidosis improved treatment outcomes and acid-base normalization rate due to succinate buffer and succinic acid metabolism. Regression of acid-base abnormalities is accelerated.

Keywords:

diabetes mellitus

diabetic ketoacidosis

crystalloid solution

infusion therapy

meglumine sodium succinate (Reamberin)

Authors:

Neymark M.I.

Altai State Medical University;
Barnaul Clinical Hospital «Russian Railways-Medicine»

ORCID: 0000-0001-9135-6392

Kloster E.A.

Barnaul Clinical Hospital «Russian Railways-Medicine»

ORCID: 0000-0002-2221-5753

Bulganin A.A.

Altai State Medical University;
Barnaul Clinical Hospital «Russian Railways-Medicine»

ORCID: 0000-0002-2057-0735

Received:

08.12.2023

Accepted:

22.01.2024

List of references:

Zabolotskikh IB, Protsenko DN. Intensivnaya terapiya: natsional’noe rukovodstvo. T. 2. 2-e izd., pererab. i dop. M.: GEOTAR-Media; 2022. (In Russ.).
Algoritmy spetsializirovannoj meditsinskoj pomoshchi bol’nym sakharnym diabetom. Dedov II, Shestakova MV, Mayorov AYu, eds. 11-j vypusk. M. 2023. (In Russ.). https://doi.org/10.14341/DM13042
Zabolotskikh IB, Malyshev YuP, Dunts PV, Lebedinskii KM, Leyderman IN, Neymark MI, Semenikhina TM, Yaroshetsky AI. Perioperative management of adult patients with concomitant diabetes mellitus: guidelines of the All-Russian public organization «Federation of Anesthesiologists and Reanimatologists» (second revision). Annals of Critical Care. 2023;1:14-33. (In Russ.). https://doi.org/10.21320/1818-474X-2023-1-14-33
Roizen MF, Fleisher LA. Perioperative management of patients with concomitant diseases. In: Anesteziya. Miller’s Anesthesia. Miller RD, ed. SPb: Chelovek; 2015(V. 2):1139-1234. (In Russ.).
Simutis IS, Boyarinov GA, Yuryev MYu, Petrovsky DS, Kovalenko AL, Sapozhnikov KV. A new look at the correction of COVID-19- mediated pulmonary gas exchange disorders. Kazanskij meditsinskij zhurnal. 2021;102(3): 362-372. (In Russ.). https://doi.org/10.17816/KMJ2021-362
Handy JM, Soni N. Physiological effects of hyperchloraemia and acidosis. British Journal of Anaesthesia. 2008;101(2):141-150. https://doi.org/10.1093/bja/aen148
Simutis IS, Boyarinov GA, Yuriev MYu, Petrovsky DS, Kovalenko AL, Sapozhnikov KV. Meglumine sodium succinate to correct COVID-19-associated coagulopathy: the feasibility study. General Reanimatology. 2021;17(3): 50-64. (In Russ.). https://doi.org/10.15360/1813-9779-2021-3-50-64
Kovalenko AL, Rizakhanov DM, Yakovlev AYu, Simutis IS, Parfenov SA, Bobovnik SV, Sorokin EP, Plexov AV, Afonchikov VS, Lebedinskii KM. Preliminary results of adding meglumine sodium succinate to the treatment of patients with moderate and severe acute pancreatitis. General Reanimatology. 2021;17(1):46-56. (In Russ.). https://doi.org/10.15360/1813-9779-2021-1-0-1
Eledrisi MS, Elzouki A-N. Management of diabetic ketoacidosis in adults: A narrative review. Saudi Journal of Medicine and Medical Sciences. 2020; 8(3):165-173. https://doi.org/10.4103/sjmms.sjmms_478_19
Kirov MYu, Gorobets ES, Bobovnik SV, Zabolotskikh IB, Kokhno VN, Lebedinskii KM, Lomivorotov VV, Lubnin AYu, Moroz GB, Musaeva TS, Neimark MI, Schegolev AV. Principles of perioperative infusion therapy in adults. Anesteziologiya i Reanimatologiya. 2018;6:82-103. (In Russ.). https://doi.org/10.17116/anaesthesiology201806182
Marino PL. Marino’s the ICU book. Yaroshetsky AI, ed. M.: GEOTAR-Media; 2022. (In Russ.).
Mæhle K, Haug B, Flaatten H, Nielsen E. Metabolic alkalosis is the most common acid-base disorder in ICU patients. Critical Care. 2014;18(2):420. https://doi.org/10.1186/cc13802
Spichak II, Kopytova EV. Application of polyionic reamberin solution in medicine and experience with its use in pediatric oncology. Onkologiya. Zhurnal im. P.A. Gertsena. 2018;7(5):47-55. (In Russ.). https://doi.org/10.17116/onkolog2018705147
Shakh BN, Lapshin VN, Kyrnyshev AG, Smirnov DB, Kravchenko-Berezhnaya NR. Metabolic effects of a succinic acid. General Reanimatology. 2014;10(1):33-42. (In Russ.). https://doi.org/10.15360/1813-9779-2014-1-33-42

Close metadata