Fluid Administration in Ketoacidosis (DRINK)

"Isotonic saline only will be used for fluid resuscitation in the first 48 hours of treatment, according to the protocol of English guidelines:~* During the first hour of treatment:~ * In the event of systolic arterial hypotension (SAP\<90mmHg): administration of 500 mL over 15 minutes, renewable once, then administration of 1L over 1 hour.~ * In the absence of systolic arterial hypotension (SAP\>90mmHg): administration of 1L over 1 hour.~* Between 60 minutes and 8 hours of treatment :~ * 1L over 2 hours, repeated once, then 1L over 4 hours~ * Adjust fluid resuscitation according to clinical tolerance~* After the first 8 hours:~ * 1L over 4h then 1L over 6h~ * Clinical re-evaluation according to standard of care in participating centers"

"Ringer Lactate only will be used for fluid resuscitation in the first 48 hours of treatment, according to the protocol of English guidelines:~* During the first hour of treatment:~ * In the event of systolic arterial hypotension (SAP\<90mmHg): administration of 500 mL over 15 minutes, renewable once, then administration of 1L over 1 hour.~ * In the absence of systolic arterial hypotension (SAP\>90mmHg): administration of 1L over 1 hour.~* Between 60 minutes and 8 hours of treatment :~ * 1L over 2 hours, repeated once, then 1L over 4 hours~ * Adjust fluid resuscitation according to clinical tolerance~* After the first 8 hours:~ * 1L over 4h then 1L over 6h~ * Clinical re-evaluation according to standard of care in participating centers"