Podcast 791: Hyperglycemic Hyperosmolar State

Podcast 791: Hyperglycemic Hyperosmolar State

Contributor: Aaron Lessen, MD

Educational Pearls:

  • Hyperglycemic Hyperosmolar State (HHS) is less common than Diabetic Ketoacidosis (DKA) but is associated with a mortality rate up to 10 times greater than that seen in DKA
  • Typically seen in elderly patients with severely elevated blood glucose levels (>1000 mg/dL) and an increased plasma osmolality
    • Unlike in DKA, patients with HHS do not have elevated ketones
  • Treatment of HHS includes insulin administration along with correcting fluid and electrolyte abnormalities
  • When treating HHS, it is important to monitor and follow osmolality regularly because over-rapid correction can result in the development of cerebral edema

References

Fayfman M, Pasquel FJ, Umpierrez GE. Management of Hyperglycemic Crises: Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State. Med Clin North Am. 2017;101(3):587-606.

Gosmanov AR, Gosmanova EO, Kitabchi AE. Hyperglycemic Crises: Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State. In: Feingold KR, Anawalt B, Boyce A, et al., eds. Endotext. South Dartmouth (MA): MDText.com, Inc. Copyright © 2000-2022, MDText.com, Inc.; 2000.

Long B, Willis GC, Lentz S, Koyfman A, Gottlieb M. Diagnosis and Management of the Critically Ill Adult Patient with Hyperglycemic Hyperosmolar State. J Emerg Med. 2021;61(4):365-375.

Summarized by Mark O'Brien, MS4 | Edited by John Spartz MS4 & Erik Verzemnieks, MD

The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account.

Donate to EMM today!



Episoder(1145)

Episode 913: Vasopressors after ROSC

Episode 913: Vasopressors after ROSC

Contributor: Travis Barlock MD Educational Pearls: Recent study assessed outcomes after ROSC with epinephrine vs. norepinephrine Observational multicenter study from 2011-2018 285 patients rece...

23 Jul 20241min

Podcast 912: Narcan (Naloxone)

Podcast 912: Narcan (Naloxone)

Contributor: Taylor Lynch, MD Educational Pearls: Opioid Epidemic- quick facts Drug overdoses, primarily driven by opioids, have become the leading cause of accidental death in the U.S. for individu...

15 Jul 20246min

Episode 911: Anticholinergic Toxicity

Episode 911: Anticholinergic Toxicity

Contributor: Taylor Lynch MD Educational Pearls: Anticholinergics are found in many medications, including over-the-counter remedies Medications include: Diphenhydramine Tricyclic antidepressa...

8 Jul 20247min

Episode 910: Cellulitis Recovery Timeline

Episode 910: Cellulitis Recovery Timeline

Contributor: Aaron Lessen, MD Educational Pearls: How fast does cellulitis recover? A recent prospective cohort study took a look at this question. The study included 300 adults with cellulitis ...

2 Jul 20241min

Episode 909: Prehospital Blood Pressure Management in Suspected Stroke

Episode 909: Prehospital Blood Pressure Management in Suspected Stroke

Contributor: Aaron Lessen MD Educational Pearls: A recent study assessed EMS treatment of high blood pressure in the field 2404 patients randomized to prehospital treatment (1205) vs. usual care ...

24 Jun 20242min

Episode 908: Sympathomimetic Drugs

Episode 908: Sympathomimetic Drugs

Contributor: Taylor Lynch MD Educational Pearls: Overview: Sympathomimetic drugs mimic the fight or flight response, affecting monoamines such as dopamine, norepinephrine, and epinephrine Limited th...

17 Jun 20247min

Episode 907: Wide-Complex Tachycardia

Episode 907: Wide-Complex Tachycardia

Contributor: Travis Barlock MD Educational Pearls: Wide-complex tachycardia is defined as a heart rate > 100 BPM with a QRS width > 120 milliseconds Wide-complex tachycardia of supraventricular or...

12 Jun 20243min

Episode 906: Case Study of Hypernatremia

Episode 906: Case Study of Hypernatremia

Contributor: Aaron Lessen MD Educational Pearls: The case: A gentleman came in from a nursing home with symptoms concerning for sepsis. He was hypotensive, hypoxic, febrile, and mentally altered. ...

3 Jun 20243min

Populært innen Vitenskap

fastlegen
smart-forklart
jss
tingenes-tilstand
villmarksliv
rekommandert
vett-og-vitenskap-med-gaute-einevoll
sinnsyn
forskningno
rss-rekommandert
fjellsportpodden
rss-paradigmepodden
tomprat-med-gunnar-tjomlid
aldring-og-helse-podden
pod-britannia
rss-nysgjerrige-norge
nordnorsk-historie
diagnose
tidlose-historier
rss-overskuddsliv