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!



Avsnitt(1147)

Podcast 696: ST Elevation and Differential Diagnoses

Podcast 696: ST Elevation and Differential Diagnoses

Contributor: Peter Bakes, MD Educational Pearls: ST elevation clinical guidelines for myocardial infarction include: 2.5 mm elevation for males 2 mm elevation in males >40 in V2 and V3 1.5 mm elev...

21 Juli 20214min

Podcast 695: Einstein and Cellophane

Podcast 695: Einstein and Cellophane

Educational Pearls: Albert Einstein had chronic abdominal pain as a middle-aged man Dr. Rudolph Nissen, founder of the Nissen fundoplication, performed exploratory surgery for this pain and found an ...

20 Juli 20213min

Podcast 694: Complete Heart Block

Podcast 694: Complete Heart Block

Contributor: Nick Hatch, MD Educational Pearls: Complete heart block or 3rd degree atrioventricular (AV) block is diagnosed via EKG and occurs when electrical signals from the sinoatrial (SA) node ar...

19 Juli 20214min

Podcast 693: Humerus Fractures

Podcast 693: Humerus Fractures

Contributor: Nick Tsipis, MD Educational Pearls: Humerus fractures can be characterized as proximal, midshaft, and distal fractures Proximal humerus fracture is the second-most common fracture in eld...

14 Juli 20217min

Podcast 692: Pelvic Fractures

Podcast 692: Pelvic Fractures

Contributor: Peter Bakes, MD Educational Pearls: Pelvis is comprised of the iliac, ischium, and sacrum Three mechanisms for pelvic fractures by Young-Burgess Classification Anterior-posterior compr...

13 Juli 20214min

Podcast 691: TXA in Head Bleeds

Podcast 691: TXA in Head Bleeds

Contributor: Ricky Dhaliwal, MD Educational Pearls: CRASH 3 Trial looked at over 12,000 patients with traumatic intracranial bleeds, randomizing patients to a therapy with TXA or standard of care wit...

12 Juli 20212min

Podcast 690: Rectal Oxygen. Nice,

Podcast 690: Rectal Oxygen. Nice,

Contributor: Chris Holmes, MD Educational Pearls: In the 1700s, boxes lined the River Thames to pump smoke up the rectum to resuscitate people who had been found unconscious in the river Sea cucumber...

7 Juli 20213min

Podcast 689: Peri-Intubation Hypotension

Podcast 689: Peri-Intubation Hypotension

Contributor: Ricky Dhaliwal, MD Educational Pearls: Hypotension in patients requiring intubation should be resuscitated as much as possible While intubating, the negative inspiratory pressure goes aw...

6 Juli 20214min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
sexet
rss-ufo-bortom-rimligt-tvivel
rss-experimentet
rss-vetenskapsradion-2
hacka-livet
paranormalt-med-caroline-giertz
dumforklarat
medicinvetarna
det-morka-psyket
rss-spraket
4health-med-anna-sparre
halsorevolutionen
rss-vetenskapsradion
pojkmottagningen
rss-tidslinjen-podcast