Management

• • • • • STOP: ACE-I, Dieretic, Oral Agents (especially Metformin)
        • Fluids: NS @ 1000 ml/hr (Follow BP, UO, BUN, creatinine)
        • D5/ ½ NS ( When Glucose < 250 mg/dl)
        • Electrolytes: K <4.5 10-20 mEq/hr
        • <3.5 20-40 mEq/hr
        • PO4 < 2.0 use K-Phos
        • Insulin: 10 U bolus followed by .1 U/kg/hr; decrease when Gluc <300 but continue until AG normalizes
        • Follow Glucose, AG (not ketones), HCO3, K
        • IDENTIFY CAUSE: Infection, Ischemia, Non-complinace