HHS Flashcards
What is HHS?
Hypersmolar hyperglycaemia state
High blood sugar resulting in osmotic diuresis severe dehydration and electrolyte imbalance, without significant ketoacidosis
What is the pathophysiology of HHS?
Hyperglycaemia –> osmotic diuresis –> low Na and K
Severe volume depletion –> increased serum osmolarity >320 –> hyperviscocity
Who is HHS typically seen in?
Elderly people with type 2 DM
What are some precipitating factors of HHS?
Infection Stroke MI Trauma Medication
What is th presentation of HHS?
Fatigue, lethargy, weakness N&V Altered consciousness, headache Dehydration, hypotension Tachycardia
What investigations should be done for HHS?
FBC, U&Es
Blood glucose
Urine and bood ketones
ABG
What do FBC and U&Es show in HHS?
Hypovolaemia
Serum osmolarity >320
What does blood glucose in HHS show?
> 30
What do urine and blood ketones show?
Negative or low
What does an ABG show in HHS?
pH >7.3
Bicarb <15
What is the management of HHS?
Fluid replacement- 0.9% saline +/- K
NO INSULIN
Why do you not give insulin in HHS?
Fluid corrects hypovolaemia, which normally causes glucose to normalise without insulin
What are the complications of HHS?
Seizures
DIC
Vascular event
Rhabdomyolysis
Why does HHS cause vascular events?
Hyperviscocity
