Electrolyte and acid-base abnormalities in patients with hyperglycemic crisis attended at emergency in a general hospital in Chiclayo

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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 g...

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Autores: León-Zuloeta, Robinsón, Chávez-Pasco, Gaudhy Sujhey, Loza-Munarriz, Cesar
Formato: artículo
Fecha de Publicación:2020
Institución:Universidad Peruana Cayetano Heredia
Repositorio:Revistas - Universidad Peruana Cayetano Heredia
Lenguaje:español
OAI Identifier:oai:revistas.upch.edu.pe:article/3804
Enlace del recurso:https://revistas.upch.edu.pe/index.php/RMH/article/view/3804
Nivel de acceso:acceso abierto
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spelling Electrolyte and acid-base abnormalities in patients with hyperglycemic crisis attended at emergency in a general hospital in ChiclayoAlteraciones del equilibrio acido base y electrolíticas en pacientes con crisis hiperglicémica atendidos en emergencia de un hospital general de ChiclayoLeón-Zuloeta, RobinsónChávez-Pasco, Gaudhy SujheyLoza-Munarriz, CesarObjective: 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.Objetivo: Describir las alteraciones del equilibrio ácido base y electrolíticas en pacientes con crisis hiperglicémica atendidos en la emergencia de un hospital general de Chiclayo. Material y métodos: Serie de casos, prospectivo y de corte transversal; se seleccionaron pacientes diabéticos con crisis hiperglicémica que fueron vigilados por 3 horas. Se registraron los datos clínicos, demográficos, gases arteriales, glicemia y electrolitos. Resultados: Se evaluaron 52 pacientes con una edad promedio 55,1 ± 16,9 y 29 (55,8%) de sexo femenino. El tiempo promedio de diagnóstico fue 4,3 ± 5,4 meses; 13 (25,0%) eran episodios debut, 4 (7,7%) fallecieron. El síntoma más frecuente fue confusión mental en 14 (26,9%), 30 (57,7%) tuvieron falla renal aguda. Las alteraciones electrolíticas más frecuentes fueron hiponatremia en 26 (50,0%) e hipokalemia en 18 (34,6%). La acidosis metabólica fue más frecuente en cetoacidosis que en coma hiperosmolar (85,0 vs 15,0%; p= 0,000). La falla renal aguda ocurrió en 76,7% en cetoacidosis diabética y en 23,3% en el coma hiperosmolar (p= 0,74). Conclusiones: La frecuencia y las complicaciones de la cetoacidosis diabética y del coma hiperosmolar, así como de las alteraciones electrolíticas, muestran grandes diferencias con los datos reportados en la literatura.Universidad Peruana Cayetano Heredia2020-10-16info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionPeer-reviewed articleArtículo evaluado por paresapplication/pdfhttps://revistas.upch.edu.pe/index.php/RMH/article/view/380410.20453/rmh.v31i3.3804Revista Médica Herediana; Vol. 31 No. 3 (2020): July - September; 155-163Revista Médica Herediana; Vol. 31 Núm. 3 (2020): Julio-Setiembre; 155-163Revista Medica Herediana; v. 31 n. 3 (2020): Julio-Setiembre; 155-1631729-214X1018-130Xreponame:Revistas - Universidad Peruana Cayetano Herediainstname:Universidad Peruana Cayetano Herediainstacron:UPCHspahttps://revistas.upch.edu.pe/index.php/RMH/article/view/3804/4284info:eu-repo/semantics/openAccessoai:revistas.upch.edu.pe:article/38042020-10-16T17:06:33Z
dc.title.none.fl_str_mv Electrolyte and acid-base abnormalities in patients with hyperglycemic crisis attended at emergency in a general hospital in Chiclayo
Alteraciones del equilibrio acido base y electrolíticas en pacientes con crisis hiperglicémica atendidos en emergencia de un hospital general de Chiclayo
title Electrolyte and acid-base abnormalities in patients with hyperglycemic crisis attended at emergency in a general hospital in Chiclayo
spellingShingle Electrolyte and acid-base abnormalities in patients with hyperglycemic crisis attended at emergency in a general hospital in Chiclayo
León-Zuloeta, Robinsón
title_short Electrolyte and acid-base abnormalities in patients with hyperglycemic crisis attended at emergency in a general hospital in Chiclayo
title_full Electrolyte and acid-base abnormalities in patients with hyperglycemic crisis attended at emergency in a general hospital in Chiclayo
title_fullStr Electrolyte and acid-base abnormalities in patients with hyperglycemic crisis attended at emergency in a general hospital in Chiclayo
title_full_unstemmed Electrolyte and acid-base abnormalities in patients with hyperglycemic crisis attended at emergency in a general hospital in Chiclayo
title_sort Electrolyte and acid-base abnormalities in patients with hyperglycemic crisis attended at emergency in a general hospital in Chiclayo
dc.creator.none.fl_str_mv León-Zuloeta, Robinsón
Chávez-Pasco, Gaudhy Sujhey
Loza-Munarriz, Cesar
author León-Zuloeta, Robinsón
author_facet León-Zuloeta, Robinsón
Chávez-Pasco, Gaudhy Sujhey
Loza-Munarriz, Cesar
author_role author
author2 Chávez-Pasco, Gaudhy Sujhey
Loza-Munarriz, Cesar
author2_role author
author
description 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.
publishDate 2020
dc.date.none.fl_str_mv 2020-10-16
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Peer-reviewed article
Artículo evaluado por pares
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://revistas.upch.edu.pe/index.php/RMH/article/view/3804
10.20453/rmh.v31i3.3804
url https://revistas.upch.edu.pe/index.php/RMH/article/view/3804
identifier_str_mv 10.20453/rmh.v31i3.3804
dc.language.none.fl_str_mv spa
language spa
dc.relation.none.fl_str_mv https://revistas.upch.edu.pe/index.php/RMH/article/view/3804/4284
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidad Peruana Cayetano Heredia
publisher.none.fl_str_mv Universidad Peruana Cayetano Heredia
dc.source.none.fl_str_mv Revista Médica Herediana; Vol. 31 No. 3 (2020): July - September; 155-163
Revista Médica Herediana; Vol. 31 Núm. 3 (2020): Julio-Setiembre; 155-163
Revista Medica Herediana; v. 31 n. 3 (2020): Julio-Setiembre; 155-163
1729-214X
1018-130X
reponame:Revistas - Universidad Peruana Cayetano Heredia
instname:Universidad Peruana Cayetano Heredia
instacron:UPCH
instname_str Universidad Peruana Cayetano Heredia
instacron_str UPCH
institution UPCH
reponame_str Revistas - Universidad Peruana Cayetano Heredia
collection Revistas - Universidad Peruana Cayetano Heredia
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