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Hyperosmolar Hyperglycemic State01:21

Hyperosmolar Hyperglycemic State

Hyperosmolar Hyperglycemic State, or HHS, is a serious and life-threatening complication of type 2 diabetes mellitus. It is characterized by three main features: severe hyperglycemia, profound dehydration, and elevated serum osmolality, all occurring without significant ketoacidosis.HHS typically develops in older adults or individuals with limited access to fluids. This may result from illness, cognitive impairment, or medications such as diuretics or corticosteroids. These factors reduce...

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Related Experiment Video

Updated: May 24, 2026

Equine Enteric Glial Culture and Application to the Study of a Neural Inflammatory Mechanism in Equine Colic
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Hydroxyethylstarch 200/0.5--the horse has bolted.

Neil Soni1

  • 1Department of Anaesthetics and Intensive Care, Chelsea and Westminster Hospital, London SW10 9NH, UK. n.soni@imperial.ac.uk

Critical Care (London, England)
|February 21, 2012
PubMed
Summary

Higher molecular weight hydroxyethylstarch (HES) 200/0.5 significantly impairs renal function compared to lower molecular weight HES 130/0.42 and ringers acetate. This study provides strong evidence for HES 200/0.5

Area of Science:

  • Nephrology
  • Critical Care Medicine
  • Pharmacology

Background:

  • Hydroxyethylstarch (HES) 200/0.5 has been linked to renal dysfunction, but evidence remains inconclusive.
  • Previous studies suggest potential renal effects, leaving clinical decisions uncertain.

Purpose of the Study:

  • To investigate the impact of different fluid resuscitation agents on renal function in a shock model.
  • To compare the renal effects of higher molecular weight HES 200/0.5 against lower molecular weight HES 130/0.42 and ringers acetate.

Main Methods:

  • Utilized a two-hit animal model of shock.
  • Administered HES 200/0.5, HES 130/0.42, ringers acetate, and gelatin for fluid resuscitation.
  • Assessed renal function and tubular damage post-resuscitation.

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Main Results:

  • HES 200/0.5 was associated with significantly impaired renal function compared to other agents.
  • Lower molecular weight HES 130/0.42 and ringers acetate preserved renal function and attenuated tubular damage.
  • The study provides compelling evidence supporting the renal risks of HES 200/0.5.

Conclusions:

  • HES 200/0.5 negatively impacts renal function, reinforcing previous concerns.
  • Lower molecular weight HES and ringers acetate are superior in preserving kidney function during shock resuscitation.
  • The underlying mechanism for HES 200/0.5's nephrotoxicity requires further investigation.