Hyperosmolar hyperglycaemic state
INCOMPLETE-TODO: clinical presentation
| = HHS | Headline |
|---|---|
| Etiology | |
| Epidemiology | |
| Clinical presentation | |
| Pathogenesis | |
| Diagnostic investigations | Dxc criteria: ➥ ↑ glu (often >30) ➥ ↑ osmolality (= 2Na + Ur + Glu) (often >320) ➥ hypovolaemia ➥ WITHOUT acidosis or ketogenesis else see Diabetic ketoacidosis |
| Management | ➥ Correct dehydration + normalise osmolarity: 0.9% saline 1st L over 1h ➥ Monitor and replace K+ ➥ Correct ↑ glu: fixed rate insulin 0.05u/kg/h if glucose not correcting with fluids alone. Aim to correct no more than 5 mmol/L/h. 10% dextrose when glu<14 ➥ Treat VTE if present, otherwise don't forget prophylaxis ➥ Treat underlying cause e.g. infection. ➥ Regular VBG, regular U+Es |