How do you manage hyperglycemic hyperosmolar?
Treatment typically includes:
- Fluids given through a vein (intravenously) to treat dehydration.
- Insulin given through a vein (intravenously) to lower your blood sugar levels.
- Potassium and sometimes sodium phosphate replacement given through a vein (intravenously) to help your cells function correctly.
What is a hyperglycemic hyperosmolar state?
Hyperosmolar hyperglycemic syndrome (HHS) is a serious complication of diabetes mellitus. HHS occurs when a person’s blood glucose (sugar) levels are too high for a long period, leading to severe dehydration (extreme thirst) and confusion.
What are the ADA recommendations for fluid resuscitation in the treatment of hyperosmolar hyperglycemic state HHS )?
Fluid deficits in adults are large in HHS, being about 9 L on average. According to American Diabetes Association guidelines, fluid resuscitation with 0.9% saline at the rate of 15-20 mL/kg/h or greater is indicated to expand the extracellular volume quickly in the first hour.
How is hyperosmolar hyperglycemic state diagnosed?
What are the ADA diagnostic criteria for hyperosmolar hyperglycemic state (HHS)?
- Plasma glucose level of 600 mg/dL or greater.
- Effective serum osmolality of 320 mOsm/kg or greater.
- Profound dehydration, up to an average of 9 L.
- Serum pH greater than 7.30.
- Bicarbonate concentration greater than 15 mEq/L.
How do you treat honk?
Treatment for HONK Treatment for hyperglycaemic hyperosmolar non-ketotic coma will include fluids being given to the patient and insulin administered intravenously.
What is 160 dL in mmol L?
mg/dL in mmol/L, conversion factor: 1 mg/dL = 0.0555 mmol/L
Why is hyperglycemia worse in HHS than DKA?
In addition, DKA patients tend to be younger than HHS patients, and thereby have a higher glomerular filtration rate. Accordingly, DKA patients have a greater ability to excrete glucose in urine and can thereby limit the hyperglycemia.
Which IV fluid is best for hyperglycemia?
The initial fluid of choice is isotonic saline (0.9% NaCl), even in HHS patients or DKA patients with marked hypertonicity, particularly in patients with evidence of severe sodium deficits manifested by hypotension, tachycardia, and oliguria.
What corrects a hyperglycemic state?
Treatment is intravenous fluids and insulin. Complications include coma, seizures, and death.
What is the difference between DKA and honk?
DKA accounts for 14% of diabetes related hospital admissions. HONK is associated with insulin resistance and is most commonly seen in type 2 diabetes. It is characterised by very high glucose concentrations and renal impairment with absent ketones.
How to treat and prevent hyperglycemic hyperosmolar syndrome?
Check your blood sugar frequently to make sure you’re staying within your target range.
How to diagnose HHS?
Altered level of consciousness
What is HHS diagnosis?
The hyperosmolar hyperglycemic state (HHS) is the most serious acute hyperglycemic emergency in patients with type 2 diabetes. von Frerichs and Dreschfeld described the first cases of HHS in the 1880s in patients with an “unusual diabetic coma” characterized by severe hyperglycemia and glycosuria in the absence of Kussmaul breathing, with a fruity breath odor or positive acetone test in the urine.
What is hyperosmolar nonketotic coma?
Hyperosmolar nonketotic state (HNS) is a dangerous form of diabetic coma.This state is also known by some other terms like hyperosmolar hyperglycemic nonketotic coma (HHNKC) or hyperosmotic non-ketoic acidosis (HONK). This complication may arise in persons having any type of the diabetes, Type 1 diabetes as well as Type 2 diabetes.In HNS, the level of blood sugar continues to rise, and the