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55 cases of DKA state of consciousness on admission of patients with the relationship between mean plasma osmolality


Osmotic pressure were higher than 345mmol /,[link widoczny dla zalogowanych], L, when less than 335mm0l / L, the patients had altered consciousness, it will consider other causes neurological symptoms. Such as stroke,[link widoczny dla zalogowanych], heavy drinking and pancreatic diseases. The results with the literature abroad 350mmol / / L and 340mmol / / L or less. Modern Chinese Journal of Internal Medicine Journal0fchineseModemMedicine Health Khon parameters of SVM in Table 1 under various states of consciousness average level of plasma osmolality (mmoL / L, ± s) · 707.2 discussions with diabetic ketoacidosis (DKA) is due to a lack of insulin,[link widoczny dla zalogowanych], insulin Anti-adjusted increase in hormones, causing sugar, protein, fat metabolism disorders occur with high blood sugar, high ketone acidosis and metabolic acidosis,[link widoczny dla zalogowanych], and water, electrolyte imbalance and a series of changes as the main manifestation of the clinical syndrome. Altered mental status of patients with diabetic ketoacidosis mechanism is still not completely clear. When the diabetic patients coma or altered mental status, attention should be hypoglycemia and DKA, both clinically difficult to identify the patient's general condition and clinical manifestations of a clear distinction. Acidosis DKA patients often have symptoms associated with dehydration, and low blood sugar reactions usually manifested body sweat, cold and wet. Advent of DKA mortality in insulin previously 6O%, the invention of insulin after a 15% to 5%; in non-specialized medical institutions still as high as 19% and the mortality rate increased with increasing age. Concluded that plasma osmolality in 350mm0l / / L lower survival rate than patients with DKA, diabetic ketoacidosis and high-sugar coma hyperosmolar nonketotic syndrome in two extreme cases of metabolic disorders have many overlapping, often such plasma osmotic pressure of patients in 36Omm0l /, L or more, most of the concurrent shock, brain edema and ARDs and other serious complications had been a serious coma before admission, the chances of survival slim. Concluded that the l4 admission that coma patients, 4 patients died (about 27% mortality). The more moderate coma in 5 cases, 4 patients died soon after admission, 1 patient transferred to ICU survival after severe brain edema and ARDs, the final automatically discharged. And impairment of consciousness, is most closely the level of plasma osmotic pressure, more serious damage, the mortality rate is higher. DKA patient's degree of mental retardation and plasma osmotic pressure was almost linear relationship between the average, the majority of patients with impairment of consciousness, the plasma osmotic pressure were higher than 345mmol / / L, while less than 335mmol /, L, if the patients had altered consciousness, to should consider whether the other causes of neurological symptoms. [
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