If anything can be counted on to be constant in this world, it is change. Stacks upon stacks of journal articles, further refining or altering contemporary medical practice or contradicting each other and adding to the confusion, are continuously published at an exponential rate. Then the biases of those approaching dissemination with an agenda make the literature’s application to day-to-day practice even muddier.
This past year is no different. Here are 10 of the best articles from 2018, excluding a few of the tamsulosin, resuscitation, and other articles already covered in this column.
Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis
We’ve spent a great deal of energy over the past decade worrying about, somewhat literally, brain cells exploding when resuscitating children in diabetic ketoacidosis. In this study, four different combinations of 0.9 percent saline, 0.45 percent saline, and rates of fluid replacement were compared without any reliable differences observed.1 Effectively, it is reasonable to consider that resuscitation using a wide range of clinically appropriate rates will be without specific harms.