Application of ultrasonic cardiac output monitor in rehydration therapy of diabetic ketoacidosis

Objective To investigate the role of ultrasonic noninvasive cardiac output monitor(USCOM) in the treatment of diabetic ketoacidosis (DKA).

Methods Fifty DKA patients were selected as the study objects and randomly divided into experimental group and control group, with 25 cases in each group. The control group was given vital signs monitor to monitor vital signs, and timely adjusted the amount and speed of fluid rehydration. The experimental group was monitored using USCOM before and after the passive leg raising (PLR). Liquid reactivity was defined as stroke output difference (△SV) ≥10%, if △SV was ≥10%, it was necessary to continue liquid replenishment treatment, if △SV was < 10%, according to the actual clinical it needed to control the amount of fluid replenishment or slow down the speed of fluid replenishment. The relevant parameters of USCOM were compared in the experimental group at admission and at the end of rehydration treatment; the net fluid intake and blood glucose were compared 24, 48 and 72 h after admission; the occurrence of related clinical complications, turning negative time of urine ketone body and the length of hospital stay were compared between the two groups.

Results There was no significant difference in general clinical data between the two groups (P>0.05). The SV and cardiac output (CO) in the experimental group were significantly higher than those at admission after fluid rehydration (P < 0.001). The net fluid intake of the experimental group was significantly lower than that of the control group 48 and 72 h after admission (P < 0.05 or P < 0.001). The total number of adverse events in the experimental group was less than that in the control group. The blood glucose levels in the two groups decreased with time prolonging.The turning negative time of urine ketone body in experimental group was shorter than that in control group, but the difference was not statistically significant (P>0.05). The length of hospital stay in the experimental group was significantly shorter than that in the control group (P=0.036).

Conclusion USCOM can effectively guide the rehydration therapy of DKA patients and achieve optimal fluid management, as well as shorten the length of hospital stay and improve patients' outcomes.