Hyperosmolar hyperglycemic state laboratory findings: Difference between revisions
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| align="center" style="background:#DCDCDC;" + |[[Plasma glucose]] (mg/dL) | | align="center" style="background:#DCDCDC;" + |[[Plasma glucose]] (mg/dL) | ||
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* | * Direct measurement | ||
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* < 200 mg/dl | * < 200 mg/dl | ||
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| colspan="1" rowspan="1" align="center" style="background:#DCDCDC;" + |[[Anion gap]] | | colspan="1" rowspan="1" align="center" style="background:#DCDCDC;" + |[[Anion gap]] | ||
| colspan="1" rowspan="1" | | | colspan="1" rowspan="1" | | ||
* (Na+) – ( | * (Na<sup>+</sup>) – (Cl<sup>–</sup> + HCO3<sup>–</sup>) | ||
| colspan="1" rowspan="1" | | | colspan="1" rowspan="1" | | ||
* 7 to 13 (mEq/L) | * 7 to 13 (mEq/L) | ||
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| align="center" style="background:#DCDCDC;" + |Plasma [[ketones]] | | align="center" style="background:#DCDCDC;" + |Plasma [[ketones]] | ||
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* Direct measurement | |||
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* Negative | |||
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* Trace or negative | * Trace or negative | ||
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| align="center" style="background:#DCDCDC;" + |Urine [[ketones]] | | align="center" style="background:#DCDCDC;" + |Urine [[ketones]] | ||
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* Direct measurement | |||
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* Negative | |||
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* Trace or negative | * Trace or negative | ||
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| align="center" style="background:#DCDCDC;" + |[[Serum bicarbonate]] | | align="center" style="background:#DCDCDC;" + |[[Serum bicarbonate]] | ||
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* Direct measurement | |||
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* 23 - 29 mEq/L | * 23 - 29 mEq/L | ||
Latest revision as of 18:19, 23 October 2017
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Hyperosmolar hyperglycemic state Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Husnain Shaukat, M.D [2]
Overview
Laboratory findings consistent with the diagnosis of hyperosmolar hyperglycemic state (HHS) include plasma glucose > 600 mg/dl, serum osmolarity > 320 mOsm/kg, blood pH > 7.3, serum bicarbonate > 18 mEq/L and negative or trace positive urine or serum ketones.
Laboratory Findings
The following lab abnormalities may be found in hyperosmolar hyperglycemic state (HHS):[1][2][3][4][5][6][7]
| LAB | FORMULA/ VARIABLE | NORMAL VALUE | VALUE IN HHS |
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| Plasma glucose (mg/dL) |
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| Arterial pH |
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| Anion gap |
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| Serum osmolality |
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| Plasma ketones |
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| Urine ketones |
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| Serum bicarbonate |
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| Blood urea nitrogen (BUN), creatinine levels |
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References
- ↑ Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN (2009). "Hyperglycemic crises in adult patients with diabetes". Diabetes Care. 32 (7): 1335–43. doi:10.2337/dc09-9032. PMC 2699725. PMID 19564476.
- ↑ Chiasson JL, Aris-Jilwan N, Bélanger R, Bertrand S, Beauregard H, Ekoé JM, Fournier H, Havrankova J (2003). "Diagnosis and treatment of diabetic ketoacidosis and the hyperglycemic hyperosmolar state". CMAJ. 168 (7): 859–66. PMC 151994. PMID 12668546.
- ↑ Liamis G, Liberopoulos E, Barkas F, Elisaf M (2014). "Diabetes mellitus and electrolyte disorders". World J Clin Cases. 2 (10): 488–96. doi:10.12998/wjcc.v2.i10.488. PMC 4198400. PMID 25325058.
- ↑ Adrogué HJ, Lederer ED, Suki WN, Eknoyan G (1986). "Determinants of plasma potassium levels in diabetic ketoacidosis". Medicine (Baltimore). 65 (3): 163–72. PMID 3084904.
- ↑ Xu W, Wu HF, Ma SG, Bai F, Hu W, Jin Y, Liu H (2013). "Correlation between peripheral white blood cell counts and hyperglycemic emergencies". Int J Med Sci. 10 (6): 758–65. doi:10.7150/ijms.6155. PMC 3638300. PMID 23630441.
- ↑ Molitch ME, Rodman E, Hirsch CA, Dubinsky E (1980). "Spurious serum creatinine elevations in ketoacidosis". Ann. Intern. Med. 93 (2): 280–1. PMID 6773457.
- ↑ Gokel Y, Paydas S, Koseoglu Z, Alparslan N, Seydaoglu G (2000). "Comparison of blood gas and acid-base measurements in arterial and venous blood samples in patients with uremic acidosis and diabetic ketoacidosis in the emergency room". Am. J. Nephrol. 20 (4): 319–23. doi:10.1159/000013607. PMID 10970986.