title: A case of successful treatment of a patient with hyperglycemia of 2700 mg/dL.
abstract: A 34-year-old man with obesity who was an avid consumer of soft drinks was found in a coma after complaining of a poor physical condition for a few days. On arrival, he had hyperglycemia of 2700 mg/dL, coma, shock, sepsis, aspiration pneumonia, acute renal failure, acute pancreatitis, liver dysfunction, and systemic mycosis. The rapid infusion of a large volume of isotonic saline, insulin, antibiotics, and ulinastatin was performed, and mechanical ventilation was applied. The treatment was complicated by transient hypernatremia resulting from osmostasis, which gradually decreased. He demonstrated transient decerebrate posturing upon stimulation; however, he became conscious within a week of admission, and his associated diseases also improved. After correcting his hyperglycemia, the patient was discharged on foot. We report our case of a patient with hyperglycemia of 2700 mg/dL, which was the highest value reported in the English literature. During the correction of the hyperglycemia, transient hypernatremia occurred to prevent abrupt decrease in osmolality, which thus resulted in cell swelling.
authors.affiliation: Department of Traumatology and Critical Care Medicine, National Defense Medical College Hospital, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Honda
authors.forename: Youichi
authors.initials: Y
authors.lastname: Yanagawa
authors.forename: Keiko
authors.initials: K
authors.lastname: Terazumi
authors.forename: Kouichirou
authors.initials: K
authors.lastname: Nishi
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D001806:Blood Urea Nitrogen; D003128:Coma / Q000209:etiology / Q000628:therapy; D004636:Emergency Service, Hospital; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D006955:Hypernatremia / Q000097:blood / Q000628:therapy; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D012965:Sodium Chloride / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007328:Insulin; D012965:Sodium Chloride