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Revista Medica Herediana

Print version ISSN 1018-130XOn-line version ISSN 1729-214X

Abstract

LEON-ZULOETA, Robinsón; CHAVEZ-PASCO, Gaudhy Sujhey  and  LOZA-MUNARRIZ, Cesar. Electrolyte and acid-base abnormalities in patients with hyperglycemic crisis attended at emergency in a general hospital in Chiclayo. Rev Med Hered [online]. 2020, vol.31, n.3, pp.155-163. ISSN 1018-130X.  http://dx.doi.org/10.20453/rmh.v31i3.3804.

Objective:

To describe electrolyte and acid-base imbalances in patients with hyperglycemic crisis attended at emergency in a general hospital in Chiclayo. Methods: A case series of diabetic patients with hyperglycemic crisis that were followed for 3 hours. Clinical, demographic, blood gases, serum glucose and electrolytes were gathered from patient´s charts.

Results:

52 patients were evaluated; mean age was 55.1 ± 16.9 years and 29 (55.8%) were females. Mean time to diagnosis was 4.3 ± 5.4 months; 13 (25.0%) occurred at onset of diabetes and 4 (7.7%) died. The most common symptom was mental confusion in 14 (26,9%) of patients, 30 (57,7%) had acute renal failure. Hyponatremia in 26 (50.0%) patients and hypokalemia in 18 (34.6%) were the most common electrolyte abnormalities found. Metabolic acidosis was more frequently found in patients with ketoacidosis than in hyperosmolar coma (85.0 vs 15.0%; p<0.0001). Acute renal failure occurred in 76.7% among patients with ketoacidosis and in 23.3% of patients with hyperosmolar coma (p=0.74).

Conclusions:

the frequency and complications of diabetic ketoacidosis and of hyperosmolar coma as well as the electrolyte abnormalities differed from those reported in the literature.

Keywords : Diabetic ketoacidosis; hyperosmolar coma; hydroelectrolytic disorders; diabetes mellitus..

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