Precision Fluid Management in a Severe DKA Patient with Complicated Acute Pancreatitis: Reducing Mortality and Length of ICU Stay

Mahmoud Sami Mohammed; Eriks Sliders; Ashraf Goma Alakkad; Osama Ahmed  Rashid Ahmed; Mostafa Mahmoud  Elshahat Saleh

doi:10.18502/aacc.v12i3.21323

Mahmoud Sami Mohammed ICU Department, Madinat Zayed Hospital, AlDhafra Western Region, SEHA, United Arab Emirates
Eriks Sliders ICU Department, Madinat Zayed Hospital, AlDhafra Western Region, SEHA, United Arab Emirates
Ashraf Goma Alakkad Internal Medicine Department, Madinat Zayed Hospital, SEHA, United Arab Emirates.
Osama Ahmed Rashid Ahmed SEHA Kidney Care, Abu Dhabi, United Arab Emirates.
Mostafa Mahmoud Elshahat Saleh ICU Department, Madinat Zayed Hospital, AlDhafra Western Region, SEHA, United Arab Emirates.

DOI: https://doi.org/10.18502/aacc.v12i3.21323

Keywords: Diabetic ketoacidosis; Fluid management; CRRT; ARDS; Septic shock

Abstract

Diabetic ketoacidosis (DKA) may become life-threatening when accompanied by acute pancreatitis, sepsis, and acute respiratory distress syndrome (ARDS), resulting in a cascade of inflammation and multi-organ dysfunction. We describe a 70-year-old male with severe DKA complicated by septic shock, ARDS, and multi-organ failure, who required individualized, precision-based fluid therapy. Aggressive but closely titrated resuscitation, guided by dynamic clinical markers, together with early initiation of Continuous Renal Replacement Therapy (CRRT), achieved stabilization. This case highlights the value of adaptive fluid management and timely CRRT in critically ill patients with complex DKA.