Review of the published studies on the two-bag diabetic ketoacidosis protocol
| Reference | Study design | Hospital setting | Patients | Outcome measure |
| Grimberg et al 21 | Retrospective case–control | Single center inpatient—Philadelphia, Pennsylvania | 20 pediatric patients (mean age 12–13): 10 one-bag, 10 two-bag | Two-bag system decreased number of intravenous bags used, response time by nursing to make changes in intravenous fluids, and costs of intravenous fluid therapy |
| Poirier et al 23 | Prospective non-blinded clinical trial | Single-center pediatric emergency room—Norfolk, Virginia | 33 pediatric patients (mean age 11–14): 16 one-bag, 17 two-bag | Two-bag system decreased the time for nursing to make changes in intravenous fluids No difference in blood glucose or bicarbonate correction nor the number of intravenous bags used |
| So and Grunewalder et al 22 | Retrospective series | Single-center inpatient— Greensboro, North Carolina | 31 pediatric patients (mean age 13–14): 9 one-bag, 22 two-bag | Two-bag system corrected bicarbonate and ketone levels faster No time difference for blood glucose and pH correction |
| Current series 2010–2015 | Retrospective cohort | Single-center inpatient— Riverside, California | 383 adult patients (mean age 36–37): 249 one-bag 134 two-bag | Two-bag system closed the anion gap faster (10.94 vs 13.56 hours) No significant time difference in hospital length of stay |