Hyperosmolar coma 20% lethal
Posted on October 19, 2009
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Hyperosmolar coma is often seen in elderly type 2 diabetic patients with acute complications, similar to the clinical performance and ketoacidosis, but there is no ketones in urine, few acidosis. Due to high blood sugar and blood osmotic pressure, patients are very prone to coma, once the disease, the mortality rate is also higher than ketoacidosis coma. Handling and rescue similar to the principles and diabetic ketoacidosis.
Hyperosmolar coma, a common trigger:
1, has diabetes and without any notice, did not take regular treatment, or even other diseases due to the misuse of high glucose infusion, resulting in significantly increased blood glucose.
2, stress: infection, angina pectoris or myocardial infarction, cerebrovascular accident, surgical and other acute conditions.
3, the elderly decreased sense of thirst, drinking water hub is not sensitive to the blood caused by too little water, and so concentrated.
High blood sugar coma with diabetes more common in middle-aged men and women can suffer from. Some patients premorbid did not know that they have diabetes. Beginning of the disease may be slow to acute manifestations of light are thirst, polyuria, fatigue, began to emerge unresponsive, indifferent expression, easy and old cardio-cerebral vascular disease, or be confused with other common diseases. Patients at an early stage, such as lack of reasonable treatment, could be further developed, sustained, multi-urine, leading to dehydration, dry mouth symptoms in patients with aggravated orbital collapse, the skin loses its elasticity, rapid heart beat, consciousness and ultimately blood pressure, into the coma, shock. Because of its mortality rate as high as 20%, it must be emphasized early detection and early treatment.
The elderly, especially in patients with diabetes, the original, once the following situation, which should be highly vigilant against the possibility of high blood sugar coma: There is a gradual development of awareness of the obstacles and dry mouth, polyuria, dry skin; appear epileptic convulsions; due to pneumonia , cold, cerebral vascular accident, trauma and other diseases caused by polyuria, dehydration phenomenon; a large number of intake of sugar (or carbohydrates) after multiple urine and change of consciousness; vomiting, diarrhea, drinking water is inadequate. Patients should immediately carry out the relevant tests to the hospital for examination, blood, urine examination is diagnosis of this disease is simple and important method.
Where dubious coma caused by high blood sugar should not be fed sugar water or intravenous injection of hypertonic glucose. The treatment of high blood sugar coma, preferably under the guidance of endocrine specialist, in principle, as soon as possible to add liquid, the proper use of insulin, attention to electrolyte balance, while also concerned about the various complications.
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