There has been a nonstop debate over the use of intravenous fluids, balanced crystalloids versus normal saline, across a wide range of clinical conditions. This time, the discussion has made its way into the management of diabetic ketoacidosis (DKA).
What makes this study particularly interesting is that, despite strong opinions on both sides, the results once again remind us how challenging it can be to demonstrate meaningful clinical differences between fluid strategies. Whether you favor balanced crystalloids or normal saline, this paper is worth reading.