Articles of Interest

Dr Johnny Nie has dug up some recent articles of interest with brief summaries for your perusal.

Enjoy!

Skeptics Guide to EM reviews a recent paper on fluid choice in mild dehydration secondary to pediatric gastroenteritis.

Key points:
  • half diluted apple juice performed better than standard electrolyte solution (like pedialyte) in treating mild dehydration in pediatric patients with gastroenteritis

R.E.B.E.L.E.M reviewed euglycemic DKA. 

Key points:
  • Euglycemic DKA (DKA with glucose less than 20mmol) can happen in Type 1 and 2 DM patients, especially in those taking SGLT-2 inhibitors
  • Do not rely on glucose alone to exclude DKA: Get VBG, anion gap, and Ketones
  • Treat it just like regular DKA, aim to close AG.
  • Most common symptom is vomitting, still only present in 37% of patients
The link below also includes the name of all the SGLT-2 inhibitors
emdocs.net reviews basics and benefits of CPAP/BiPAP.
Key points:
  • CPAP/BiPAP is life saving and intubation avoiding
  • Strong benefit (NNT 4-10) demonstrated in COPD and CHF patients
  • Avoid in patients with facial trauma, unprotected airway, vomitting
  • Should be considered in asthmatic and neurodegenerative disorders. However evidence less strong.
  • Make sure to get VBG to assess response/necessity for intubation

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