What happens to electrolytes in HHS?

What happens to electrolytes in HHS?

HHS produces significant loss of several electrolytes as well as a prerenal azotemia and increased hematocrit, the latter due to hemoconcentration. An increase of serum sodium in the presence of hyperglycemia indicates severe dehydration.

Do you give potassium in HHS?

Potassium may be added to the infusion fluid and should be started at a level of 3.5 mEq/L or less and with adequate urine output. Usually, replenishing potassium with 20-30 mEq of potassium chloride in each liter of IV fluid is sufficient. The goal is to keep a potassium level of between 4 and 5 mEq.

Why does HHNS cause hypokalemia?

Hypokalemia or hyperkalemia may be present. Commonly, at time of presentation of HHS, serum potassium may be elevated due to an extracellular shift caused by insulin deficiency. However, total body potassium is likely low regardless of its serum value. The average potassium deficit in normally about 300-600 mEq.

Does HHS cause hypernatremia or hyponatremia?

Hyperosmolar hyperglycemic state (HHS) is a life-threatening endocrine disorder that most commonly affects adults with type 2 diabetes mellitus. It is characterized by severe dehydration with hypernatremia, marked hyperglycemia, variable degrees of neurologic impairment and mild or no ketosis.

Can dehydration cause HHS?

In the presence of HHS, if the renal water loss is not compensated for by oral water intake, dehydration leads to hypovolemia. The development of hyperosmolarity and hypotension can be accelerated by any process that accelerates water loss, such as diarrhea or severe burns.

Why is dextrose given in HHS?

The cornerstone of DKA and HHS management is insulin therapy. Prospective randomized studies have clearly established the superiority of low-dose insulin therapy in that smaller doses of insulin result in less hypoglycemia and hypokalemia.

What electrolytes are monitored in the acute stage of DKA?

Potassium, bicarbonate, and phosphate therapy Serum potassium should be closely monitored during DKA treatment.

What is hyperosmolar hyponatremia?

Hyperosmolar hyponatremia. This is a “dilutional” hyponatremia. Essentially, it is the result of water moving into the extracellular fluid to dilute whatever extraneous osmotically active agent is present there. Historically, such hyponatremia has not yet appeared in the CICM fellowship exam.

What are the signs and symptoms of hyperosmolar hyperglycemic state?

In children and adolescents, hyperosmolar hyperglycemic state is often present when type 2 diabetes is diagnosed. Physical findings include profound dehydration and neurologic symptoms ranging from lethargy to coma. Treatment begins with intensive monitoring of the patient and laboratory values, especially glucose,…

Can hyperosmolar hyperglycemic syndrome (HHS) be prevented?

Can hyperosmolar hyperglycemic syndrome (HHS) be prevented? The best way to prevent HHS is by following a healthy lifestyle and managing your diabetes.

Can fluid and electrolyte disturbances be observed in tube fed patients?

FLUID AND ELECTROLYTE DISTURBANCES ASSOCIATED WITH TUBE FEEDINGS Tube-fed patients tend to have the fluid and electrolyte dis- turbances associated with their underlying disease and treatment conditions. Theoretically, then, it should be pos- sible to observe all types of electrolyte disturbances in tube- fed patients.