[No free water in the treatment of "hyperosmolar diabetic coma": treatment control by comparing serum and CSF (author's transl)].
Some serum and CSF concentrations were measured in five patients with severe hyperosmolar coma (mean blood sugar = 58.9 mmol/l; osmolarity = 406 mosmol/l). A gradual decrease of serum osmolarity prevented the development of an osmotic gradient between CSF and extracellular space. Insulin treatment (1-20 IU/h) with a motor infusion pump and infusion of hypertonic solutions decreased serum osmolarity by 2-4 mosmol/l X h. The faster fall of glucose in the extracellular space was compensated by hypertonic saline infusions (up to 365 mosmol/l). All patients survived.
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003926:Diabetic Coma / Q000097:blood / Q000134:cerebrospinal fluid / Q000188:drug therapy / Q000378:metabolism*; D004573:Electrolytes / Q000378:metabolism; D005110:Extracellular Space / Q000378:metabolism; D005260:Female; D005947:Glucose / Q000134:cerebrospinal fluid; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration
D001786:Blood Glucose; D004573:Electrolytes; D007328:Insulin; D005947:Glucose
Kein freies Wasser bei der Therapie des "Coma diabeticum hyperosmolare"! Therapiekontrolle durch Vergleich von Serum und Liquor.