To compare the clinical efficacy and safety of sodium bicarbonate ringer’s injection and 0.9% NaCl as resuscitation fluid in the treatment of patients with diabetic ketoacidosis (DKA).

Patients with DKA were randomly divided into treatment group and control group. After enrollment, the treatment group was immediately given sodium bicarbonate ringer’s , and the control group was given 0.9% NaCl for fluid resuscitation. Other treatment protocols for DKA were the same in two groups. The incidence of hyperchloremia in 96 hour the change value of chloride in 96 hours (with the maximum value minus the baseline value), the total volume of fluid administered over 24 hours, the volume of urine produced over 24 hours, and the incidence of acute kidney injury(AKI) were compared between the two groups. Additionally, the incidence of hypokalemia in the two groups during the 96-hour observation period was recorded, and the safety of the intervention was evaluated.

The study cohort comprised 20 cases in the treatment group, of whom two were dislodged, finally 18 cases were included in the statistical analysis. In the control group, 20 cases were enrolled, with one case being dislodged, leaving 19 cases included in the statistical analysis. The incidence of 96 hour hyperchloraemia in the treatment group and the control group was 27.78% (5 cases/18 cases) and 73.68% (14 cases/19 cases), respectively. Furthermore, the change values of chloride in 96 hour were 11.05(9.30, 13.13) and 19.10(14.10, 29.10) mmol·L^-1, respectively. Notably, the differences between the two groups were statistically significant(all P<0.05). The total fluid volume was 3 410.00 and 3 600.00 mL, the 24 hour urine output was 2 075.00 and 2 950.00 mL, and the incidence of AKI was 0% (0 cases/18 cases) and 5.26% (1 cases/19 cases) in the treatment group and the control group, respectively. No statistically significant differences were observed in any of the statistical comparisons(all P>0.05). However, the incidence of hypokalaemia in the treatment group(22.22%) was lower than that in the control group(57.89%), and this difference was statistically significant (P<0.05).

The administration of sodium bicarbonate ringer’s injection for the resuscitation of patients with diabetic ketoacidosis has been demonstrated to reduce the incidence of hyperchloremia at 96 hours, and have good safety.