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Related Experiment Videos

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
PubMed
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.

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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.

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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.