Abstract:
This paper focuses on hyperglycemic hyperosmolar syndrome (HHS), a unique hyperglycemic state requiring divergent diagnosis and treatment approaches from diabetic ketoacidosis (DKA) despite some shared characteristics. We introduce the mnemonic DI-FF-ER-EN-CE-S to encapsulate unique HHS management and complications. \'DI\' emphasizes the need to delay and decrease initial insulin therapy until serum glucose decline is managed by fluid resuscitation alone. \'FF\' stresses the importance of double fluid replacement compared to DKA due to severe dehydration and \'ER\' electrolyte replacement due to profound losses and imbalances. \'EN\' denotes the potential for encephalopathy and the requirement for a controlled serum osmolality reduction. \'CE\' indicates cerebral edema, a rare complication in HHS. \'S\' signifies systemic multiorgan failure. We categorize the associated risks into three mnemonic groups: the 3Rs (renal failure, respiratory distress, rhabdomyolysis), the 3Hs (heart failure, hypercoagulation, hyperthermia), and AP (arrhythmias, pancreatitis) to facilitate awareness and screening of HHS.
摘要:
本文主要研究高血糖高渗综合征(HHS),糖尿病酮症酸中毒(DKA)是一种独特的高血糖状态,尽管有一些共同的特征,但需要不同的诊断和治疗方法。我们引入助记符DI-FF-ER-EN-CE-S来封装独特的HHS管理和并发症。“DI”强调需要延迟和减少初始胰岛素治疗,直到仅通过液体复苏来控制血清葡萄糖下降。与DKA相比,“FF”强调了双重液体置换的重要性,这是由于严重的脱水和严重的损失和不平衡导致的“ER”电解质置换。\'EN\'表示脑病的可能性和对受控血清渗透压降低的要求。\'CE\'表示脑水肿,HHS罕见的并发症。\'S\'表示全身性多器官衰竭。我们将相关风险分为三个记忆组:3Rs(肾衰竭,呼吸窘迫,横纹肌溶解),3Hs(心力衰竭,高凝,热疗),和AP(心律失常,胰腺炎),以促进对HHS的认识和筛查。