Related Experiment Videos
Hyperosmolar non-ketotic diabetic coma -- less sodium in therapy?
Anaesthesia and Intensive Care
|August 1, 1980
Summary
Hyperosmolar non-ketotic diabetic coma primarily affects older women, with mortality linked to age and complications. Optimal treatment involves gradual fluid and electrolyte replacement to manage persistent high serum osmolarity.
Area of Science:
- Endocrinology
- Metabolic Disorders
- Internal Medicine
Background:
- Hyperosmolar non-ketotic coma is a severe diabetic complication.
- It disproportionately affects elderly women, often with undiagnosed diabetes.
Purpose of the Study:
- To identify prognostic factors in hyperosmolar non-ketotic coma.
- To review current treatment strategies and outcomes.
Main Methods:
- Retrospective study of 18 patients with hyperosmolar non-ketotic coma.
- Analysis of patient demographics, clinical data, and treatment responses.
Main Results:
- Mortality rate was 44%, correlated with advanced age (>60), uremia, and hyperosmolarity.
- Hyperglycemia responded to insulin and rehydration, but serum osmolarity remained elevated for days.
- Initial fluid and electrolyte shifts included increased serum sodium in 78% and osmolarity in 22%.
Conclusions:
- Age, uremia, and hyperosmolarity are key mortality predictors.
- Gradual fluid and electrolyte replacement over 48 hours, using 5% dextrose for water deficits, can prevent worsening hyperosmolarity without risking cerebral edema.