Cetoacidosis diabética y estado hiperosmolar

Diabetic ketoacidosis and hyperosmolar state

Contenido principal del artículo

Johanna Barbosa J.
William Rojas

Resumen

La cetoacidosis diabética y el estado hiperosmolar han generado en su terapéutica grandes controversias en cuanto al manejo de la insulinoterapia y la reposición de líquidos y electrolitos. Aunque su fisiopatología es muy similar, las características de los pacientes son completamente diferentes y esto crea dificultades en el abordaje terapéutico. En la presente revisión se pretende aclarar de una manera sencilla las diferencias fisiopatplógicas de ambas entidades y, por lo tanto, las diferencias terapéuticas.

Descargas

Los datos de descargas todavía no están disponibles.

Detalles del artículo

Referencias

1. Ennis E, Kreisberg R, Diabetic ketoacidosis and the hyperglycemic hyperosmolar syndrome In: Leroith D., Taylor S, Olefsky J, eds. Diabetes Mellitus. Philadelphia: Lippincott Rayen; 1996: 276-85.

2. Davidson Mayer B. Diabetes Mellitus. Diagnosis and Treatment. 4th edition. Philadelphia: Saunders; 1999: 159-94.

3. Reichard GA, Skutches CL, Hoeldtke RD1. Acetone metabolism in humans during diabetic ketoacidosis. Diabetes. 1986; 35(2): 668-74.

4. Brandt KR, Miles JM . Relationship between severity of hyperglycemia and metabolic acidosis in diabetic ketoacidosis. Mayo Clin Proc. 1988;63(11): 1071-4.

5. Salem MM, Mujais SK. Gaps in the anion gap.Arch. Intern Med. 1992;152(8):1625- 9.

6. Kitabchi AE, Wall BM. Diabetic Ketoacidosis. Med Clin North Am. 1995; 79:9-37.

7. Lebovitz HE.. Diabetic Ketoacidosis. Lancet. 1995; 345:767-72.

8. Abourizk NN. Diabetic Ketoacidosis in pregnancy: Another atypical case comment]. Diabetes Care.1993; 16(4):661-2.

9. Chauhan SP, Perry KG Jr. Management of diabetic Ketoacidosis in the obstetric patient. Obstet Gynecol Clin North Am. 1995; 22(1):143-5.

10. Garner P. Type I diabetes mellitus and pregnancy. Lancet. 1995; 346 (8968):157-61.

11. Ramin K. Diabetic Ketoacidosis in pregnancy, Obstet Gynecol Clin North Am. 1999; 26(3): 481-8.

12. Bohan J, Fulop M. Chemical measurements in ketoacidosis, Arch Intern Med. 1999; 159(17):2089.

13. Fulop M, Vadiraja M. Serum beta hydroxybutyrate measurement in patients with uncontrolled diabetes mellitus, Arch Intern Med. 1999; 159(4): 381-4.

14. Fleckman AM.Diabetic Ketoacidosis. Endocrinol Metab Clin North Am.1993;22(2): 181-207.

15. Defronzo RA, Matsuda M, Barrett EJ. Diabetic ketoacidosis: a combined metabolic- nephrologic approach to therapy. Diabetes Rev. 1994 2: 209-211.

16. Adrogue HJ, Barrero J, Eknoyan G. Salutary effects of modest fluid replacement in the treatment of adults with diabetic ketoacidosis. _JAMA . 1989;262: 2108-13.

17. Kannan CR, Mazzone T Diabetic ketoacidosis In:Parrilo J, Current Therapy in Critical Care Medicine.2nd ed. St Louis, MO: Mosby; 1997: 373-8.

18. Grimberg A., Cerri R., Satin-Smith M. The "two bag system" for variable intravenous dextrose and fluid administration: Benefits in diabetic ketoacidosis management. J Pediatr. 1999; 134(3):376-8.

19. Okuda Y, Adrogue HJ, Field JB. Counter-productive effects of sodium bicarbonate in diabetic ketoacidosis. J. Clin. Endocrinol Metab. 1996; 81(1): 314-20.

20. Viallon A, Zeni F, Lafond P, et al. Does bicarbonate therapy improves the management of severe diabetic ketoacidosis? Crit Care Med. 1999; 27(12): 2690-3.

21. Adrogue HJ, Madias NE. Management of life-threatening acid-base disorders. N Engl J Med. 1998; 338:26-34.

22. Marinac J, Mesa L. Using a severity of illness scoring system to assess intensive care unit admissions for diabetic ketoacidosis, Crit Care Med. 2000; 28(7):2238-41.

23. kitabchi A, Wall B, Management of diabetic ketoacidosis. Am Fam Physician.1999, 60:455-64.

24. Ennis ED, Stahl EJ, Kreisberg RA. The hyperosmolar hyperglycemic syndrome. Diabetes Rev. 1994 2: 115-8.

25. Brandenburg M, Dire D., Comparison of arterial and venus blood gas values in the initial emergency departmen evaluation of patients with diabetic ketoacidosis, Ann Emerg Med. 1998; 31(4):459-65.

26. Green 5, Rothrock 5. Failure of adjunctive bicaarbonate to improve outcome in severe pediatric diabetic ketoacidosis, Ann Emerg Med. 1998;31(1):41-8 .

27. Kannan R.C. Bicarbonate therapy in the management of severe diabetic ketoacidosis. Crit Care Med. 1999; 27(12):2833-4.

28. Singhal PC, Abramovici M, Venkatesan J. Rhabdomyol-yis in the hyperosmolal state. Am J Med. 1990 ;88(1):9-12.

29. Caramori MLA, Gross JL, Friedman R. Pneumo-mediastinum And Subcutaneous emphysema in diabetic ketoacidosis. Diabetes Care. 1995; 18(9): 1311-2.

30.Rosenbloom A, Cerebral Edema in Diabetic Ketoacidosis, J. Clin Endocrinol Metab. 2000, 85: 507-8.

31. Muir A, Cerebral Edema in Diabetic Ketoacidosis: A Look Beyond Rehydration, J Clin Endocrinol Metab. 2000; 85: 509-13.

32. Hammond P, Wallis S. Cerebral edema in diabetic ketoacidosis: Still puzzling and often fatal. BMJ. 1992; 305(6847):203-4.

33. Bello FA, Stone JF. Cerebral edema in diabetic ketoacidosis in children. Lancet. 1990; 336(8706): 64.

34. Couch RM, Accott PD, Wong GWK. Early onset fatal cerebral edema in diabetic ketoacidosis. Diabetes Care. 1991; 14(1): 78-9.

35. Samos F, Roos B. Diabetes Mellitus in older persons, Med Clin North Am. 1998; 82(4):791-803.

36. Balasubramanyam A, Zern J. New profiles of diabetic ketoacidosis: Type 1 vs type 2 diabetes and the effect of ethnicity, Arch Intern Med. 1999;159(19):2317-22.

Citado por