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Hypoglycaemic shock: normal or abnormal response to injury?
R O Ofiaeli1, C C Anyaegbu, C E Dioka
1Department of Surgery, Nnamdi Azikiwe University, Anambra State, Nigeria.
Tropical Doctor
|August 13, 1998
Summary
Hypoglycaemic shock can occur in trauma patients up to 18 hours post-injury, challenging the assumption of hyperglycemia. Prompt dextrose administration rapidly restored consciousness in a case of severe hypoglycemia following trauma.
Area of Science:
- Trauma Medicine
- Endocrinology
- Emergency Medicine
Background:
- The metabolic response to trauma is typically characterized by a hyperglycaemic state due to stress hormones.
- Hypoglycemia is an uncommon but serious complication in trauma patients.
Observation:
- A patient involved in a road traffic accident sustained multiple rib fractures and lumbar bruising.
- The patient developed symptoms of hypoglycaemic shock, including weakness, sweating, disorientation, and coma, 18 hours after injury and 11 hours after his last meal.
Findings:
- Intravenous administration of 50 ml of 50% dextrose rapidly reversed the hypoglycaemic shock and restored consciousness.
- This case highlights that severe hypoglycaemia can manifest in trauma patients, contrary to the usual hyperglycaemic response.
Implications:
- Clinicians should consider the possibility of delayed hypoglycaemia in trauma patients, even in the absence of pre-existing diabetes.
- Early recognition and treatment of hypoglycaemia are crucial for preventing severe neurological complications in trauma cases.
- This case underscores the need for vigilant glucose monitoring in trauma patients, irrespective of the expected metabolic response.
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