Hiperosmolar non ketotik pdf

Diabetic coma occurs when blood sugar gets too high and the body becomes severely dehydrated. Sindrome hiperglikemia hiperosmolar non ketotik mengambarkan kekurangan hormon insulin dan kelebihan hormon glukagon. Hyperosmolar hyperglycemic state hhs is the nomenclature recommended by the american diabetes association to emphasize the varying alterations in sensorium less than coma that are usually present in humans and that hhs may occur with mild ketosis and acidosis nugent, 2005. Although typically occurring in the elderly, hhs is presenting in ever younger adults and teenagers, often as the initial presentation of type 2 diabetes mellitus t2dm. Laporan pendahuluan askep diabetes melitus dm pdf doc. Hyperosmolar nonketotic state associated with quetiapine. Mellitus berasal dari bahasa latin yang bermakna manis atau madu.

Onsetnya lambat dengan poliuria selama 23 minggu dan dehidrasi progresif. Your body gets rid of the extra sugar through your urine. Dua kondisi di atas dapat dialami oleh penderita diabetes mellitus dm. Hiperosmolar hipergligemik non ketotik hhnk adalah komplikasi metabolik akut lain dari diabetes yang sering terjadi pada penderita diabetes tipe 2 yang lebih tua. In brief diabetic ketoacidosis dka and hyperosmolar hyperglycemic syndrome hhs are two acute complications of diabetes that can result in increased morbidity and mortality if not efficiently and effectively treated. Seven of these were complicated by other illnesses. Twelve cases of diabetic hyperosmolar coma without ketosis are described in ten patients. Management of the hyperosmolar hyperglycaemic state hhs. Gejala klinis utama adalah dehidrasi berat, hiperglikemia berat dan seringkali disertai gangguan. Estado hiperosmolar hiperglucemico diabetes education online. Client concerns included polydipsia, polyuria, and lethargy. Diabetic ketoacidosis dka and hyperglycemic hyperosmolar state hhs are the most serious and lifethreatening hyperglycemic emergencies in patients with diabetes. Hiperglikemia hiperosmolar non ketotik panduan praktik.

Hiperglikemia berat dengan kadar glukosa serum lebih besar dari 600 mgdl. Nov 17, 2016 hiperglikemik hiperosmolar non ketotik hhnk merupakan komplikasi akut pada dm tipe 2 berupa peningkatan kadar gula darah yang sangat tinggi 600mgdl1200mgdl dan ditemukan tandatanda dehidrasi tanpa disertai gejala asidosis. Course and prognosis of 2 patients with diabetic non ketotic hyperosmolar state. Although there are important differences in their pathogenesis, the basic underlying mechanism for both disorders is a reduction. Sindrom koma hiperglikemik hiperosmolar non ketotik. Coma hiperosmolar hiperglucemico no cetosico by rocio. Diabetic ketoacidosis dka and hyperglycemic hyperosmolar state hhs are the most serious and lifethreatening hyperglycemic emergencies in diabetes. The hyperglycaemic hyperosmolar state hhs is a medical emergency. If you continue browsing the site, you agree to the use of cookies on this website.

Clinical and metabolic characteristics of hyperosmolar. Hiperglikemia hiperosmolar non ketotik adalah suatu komplikasi akut dari diabetes melitus di mana penderita akan mengalami dehidrasi berat, yang bisa menyebabkan kebingungan mental, pusing, kejang dan suatu keadaan yang disebut koma. Hyperglycaemic hyperosmolar nonketotic coma is a short term complication requiring immediate treatment by a healthcare professional. Seven died, but in five death was probably not due to the hyperosmolar state.

The management of the hyperosmolar hyperglycaemic state. Diabetic ketoacidosis occurs more commonly with type 1. Hyperosmolar hyperglycemic state linkedin slideshare. Bukan karena defisiensi insulin absolut, namun relatif, hiperglikemia muncul tanpa ketosis. It is a lifethreatening emergency that, although less common than its counterpart, diabetic ketoacidosis dka, has a much higher mortality rate, reaching up to 510%. Hhs dan dka adalah kondisi emergensi di bidang endokrinologi. Hiperosmolar nonketotik adalah suatu keadaan dimana kadar glukosa darah.

The goals of treatment are to provide frequent patient monitoring, to treat the underlying cause and to gradually and safely. Waters et al3 listed the etiologies of excess lactic acid. Evaluation at presentation revealed profound dehydration, lactic acidosis, and azotemia. Diabetic hyperosmolar syndrome can take days or weeks to develop. Komplikasi akut diabetes melitus ketoasidosis diabetikkad, hiperglikemik hiperosmolar non ketotikhhnk dan hipoglikemia akan semakin. Over the past few decades, hyperosmolar hyperglycemic state has had many names and including nonketotic hypertonicity, hyperosmolar nonketosis, and, most often, hyperosmolar afp by topic app afp community blog afp on facebook afp on twitter afpfpm careercenter advertisement. Di amerika, dari penelitian yang dilakukan oleh american diabetes association angka kematian klien dengan hiperglikemia hiperosmolar non ketotik pada tahun 2009 cukup tinggi,yaitu 4050%, lebih tinggi dari pada diabetik ketoasidosis.

Hyperosmolar hyperglycemic state hhs endocrine and. Mortality rates are 25% for dka and 15% for hhs, and mortality is usually a consequence of the underlying precipitating causes rather than a result of the metabolic. Concepts of fluid therapy in diabetic ketoacidosis and hyperosmolar hyperglycemic nonketotic coma. Hyperosmolar hyperglycemic state hhspreviously referred to as hyperglycemic hyperosmolar nonketotic coma hhnk and nonketotic hyperosmolar syndrome is a complication of type 2 diabetes mellitus and has an estimated mortality rate of up to20%, which is significantly higher than the mortality for diabetic ketoacidosis currently 1%. Hiperglikemia hiperosmolar non ketotik adalah suatu komplikasi akut dari diabetes melitus di. Hhnk juga disebut koma hiperglikemik hiperosmolar non ketotik atau. In addition to timely identification of the precipitating cause, the first step in acute management of these disorders includes aggressive administration of intravenous fluids with appropriate replacement of electrolytes primarily. Hhs can occur in people with type 1 or type 2 diabetes, but is more common in people with type 2 diabetes. Diabetic hyperosmolar syndrome symptoms and causes mayo. Lactic acidosis has elicited considerable clinical interest since1961 when huckabee1,2 drew attention to it as a clinical entity. Diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome the two most common lifethreatening complications of diabetes mellitus include diabetic ketoacidosis dka and hyperglycemic hyperosmolar syndrome hhs.

Hyperglycaemic hyperosmolar nonketotic coma is a dangerous condition brought on by very high blood glucose levels in type 2 diabetes above 33 mmoll. Webmd tells you the symptoms to look out for and how its treated. Hiperosmolar non ketotik pdf in many hospitals these patients are managed by non specialist teams, and it is not uncommon for the most junior member, who is least likely to be aware. Symptoms include signs of dehydration, weakness, leg cramps, vision problems, and an altered level of consciousness. Hiperglikemik hiperosmolar non ketosis adalah keadaan koma akibat dari komplikasi diabetes melitus di mana terjadi gangguan metabolisme yang menyebabkan. Coma hiperosmolar, hiperglucemico no cetosico sciencedirect. Hyperosmolar hyperglycemic state winchester hospital. Hyperglycemic hyperosmolar nonketotic syndrome hhns was infrequently diagnosed till recently. Penurunan insulin menyebabkan hambatan pergerakan glukosa ke dalam sel, sehingga terjadi akumulasi glukosa di plasma.

Hyperosmolar hyperglycemic state hhs is a complication of diabetes mellitus in which high blood sugar results in high osmolarity without significant ketoacidosis. Symptoms of honk before loss of consciousness and coma takes place, patients will display signs of. Definitions dka consists of the biochemical triad of hyperglycemia, ketonemia and metabolic high anion gap acidosis the term hyperglycemic hyperosmolar nonketotic coma has been replaced with the term hyperglycemic hyperosmolar state hhs 1the hyperglycemic hyperosmolar state may consist of moderate to variable degrees of. Pathophysiological considerations and suggested guidelines for treatment phil zeitler, md, phd, andrea haqq, md, arlan rosenbloom, md, and nicole glaser, md for the drugs and therapeutics committee of the lawson wilkins pediatric endocrine society h yperglycemic hyperosmolar syndrome hhs, charac. Hhs is different from diabetic ketoacidosis dka and treatment requires a different approach. The sudden increased level of sugar result in hypotension and tachycardia, complicating into coma and death. Diabetic hyperglycemic hyperosmolar syndrome hhs is a complication of type 2 diabetes.

Diabetic hyperosmolar syndrome symptoms and causes. Jan 14, 2019 hyperosmolar hyperglycemic state hhs is one of two serious metabolic derangements that occur in patients with diabetes mellitus dm. Hiperglikemik hiperosmolar non ketotik hhnk merupakan komplikasi akut pada dm tipe 2 berupa peningkatan kadar gula darah yang sangat tinggi 600mgdl1200mgdl dan ditemukan tandatanda dehidrasi tanpa disertai gejala asidosis. Ketoasidosis diabetik dan hiperosmolar non ketotik, keduanya dapat terjadi karena kadar insulin yang. Hyperosmolar hyperglicemic state hhs adalah sindrom yang merupakan kumpulan gejala. Clinical and metabolic data of twenty patients with hyperosmolar nonketotic coma hnc and ten patients in ketoacidosis da are compared. Although dka and hhs are often discussed as separate entities, they represent points along a spectrum of hyperglycemic emergencies due to poorly controlled diabetes. Ketotik pada tahun 2009 cukup tinggi,yaitu 4050%, lebih tinggi dari pada diabetik ketoasidosis. Hyperosmolar hyperglycemic state previously referred to as hyperglycemic hyperosmolar nonketotic coma hhnk and nonketotic hyperosmolar syndrome nkhs is a complication of type 2 diabetes mellitus and has an estimated mortality rate of up to 20%, which is significantly higher than the mortality for diabetic ketoacidosis currently hiperosmolar non ketotik adalah suatu komplikasi akut dari diabetes melitus di mana penderita akan mengalami dehidrasi berat, yang bisa menyebabkan kebingungan mental, pusing, kejang dan suatu keadaan yang disebut koma. Symptoms include signs of dehydration, weakness, leg cramps, vision problems, and an altered level of. Penyakit diabetes melitus dapat diartikan individu yang mengalirkan volume urine yang banyak dengan kadar glukosa tinggi. Complicacoes hiperglicemicas agudas denise momesso endocrinologia medica cti pro cardiaco 2.

The hyperosmolarity in this syndrome is due to either gross hyperglycemia or. Diabetic ketoacidosis and hyperosmolar hyperglycemic. Hipoglikemia dapat terjadi seumur hidup selama program pengobatan yang disebabkan karena efek samping pemberian obat stimulus insulin dalam tubuh maupun obat insulin dari luar cryer, 2010. Hyperosmolar hyperglycemic state discharge care what. Hyperosmolar hyperglycaemic state symptoms, diagnosis. Hyperosmolar hyperglycemic nonketotic syndrome vs dka. Waspadai hiperglikemi hiperosmolar nonketotik bagi penderita.

Unduh sebagai pptx, pdf, txt atau baca online dari scribd. Diabetic ketoacidosis and hyperglycemic hyperosmolar. Hyperosmolar hyperglycemic state previously referred to as hyperglycemic hyperosmolar nonketotic coma hhnk and nonketotic hyperosmolar syndrome nkhs is a complication of type 2 diabetes mellitus and has an estimated mortality rate of up to 20%, which is significantly higher than the mortality for diabetic ketoacidosis currently hyperosmolar hyperglycemic state, or hhs, is another acute and lifethreatening complication of diabetes mellitus. Diabetic ketoacidosis dka and hyperosmolar hyperglycemic state hhs are similar but distinct diabetic emergencies that are frequently encountered in the ed. Features of the 2 disorders with ketoacidosis and hyperosmolality may coexist. Neurologic and respiratory signs occurred frequently. Jul 23, 2015 sebuah panduan protokol penanganan hhs digambarkan dengan baik pada diagram di atas kitabchi dkk, 2006. Hyperosmolar hyperglycemic state is a lifethreatening emergency manifested by marked eleva tion of blood glucose, hyperosmolarity, and little or no ketosis. They are part of the spectrum of hyperglycemia, and each represents an extreme in the spectrum.

Diabetic ketoacidosis dka and hyperosmolar hyperglycemic state hhs, also known as hyperosmotic hyperglycemic nonketotic state hhnk are two of the most serious acute complications of diabetes. Hyperosmolar nonketotic state hhs or coma happens in people with diabetes. Hyperosmolar hyperglycemic state hhs is a serious medical condition that develops if your blood sugar levels get very high. Hiperosmolar non ketotik pdf in many hospitals these patients are managed by nonspecialist teams, and it is not uncommon for the most junior member, who is least likely to be aware. Now it is being diagnosed with increasing frequency in obese children with type 2 diabetes mellitus. Unlike the other common diabetes emergency, diabetic ketoacidosis dka, guidelines on the management of the hyperglycaemic hyperosmolar state hhs in adults are uncommon and often there is little to differentiate them from the management of dka. Berikut ini laporan pendauluan askep diabetes melitus dm pdf doc definisi diabetes berasal dari bahasa yunani yang berarti mengalirkan atau mengalihkan siphon. The emergencies of diabetic ketoacidosis and a nonketotic hyperosmolar state can occur with both type 1 and type 2 diabetes. Hyperglycemic, hyperosmolar syndrome in feline diabetics. Common precipitating factors in hnc included infection, dehydration and administration of diabetogenic drugs. Complicacoes hiperglicemicas agudas cetoacidose diabetica cad estado hiperglicemico hiperosmolar shh 3. Sindrom hiperglikemi hiperosmolar nonketotik hhnk disebut juga hyperosmolar hyperglycemic syndrome adalah kondisi yang terjadi ketika.

Hhnk ditandai oleh hiperglikemia, hiperosmolar tanpa disertai adanya ketosis. Blood sugar level of 600 milligrams per deciliter mgdl or 33. The nursing care plan for clients with diabetic ketoacidosis and hyperglycemic hyperosmolar nonketotic syndrome includes provision of information about disease processprognosis, selfcare, and treatment needs, monitoring and assistance of cardiovascular, pulmonary, renal, and central nervous system cns function, avoiding dehydration, and. Diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome hhs are life threatening complications that occur in patients with diabetes. Pdf hyperosmolar nonketotic state associated with quetiapine.

Mar 15, 2019 hiperosmolar non ketotik pdf in many hospitals these patients are managed by non specialist teams, and it is not uncommon for the most junior member, who is least likely to be aware. Hyperglycemic, hyperosmolar syndrome was seen in older cats that were often long. Also referred to as hyperosmolar hyperglycemic state hhs, nonketotic hyperosmolar coma nkhoc is an acute complication of diabetes meillitus type 2. Dka is more common in young people with type 1 diabetes and hhs in adult and elderly patients with type 2 diabetes. Patients with dka or hhs present with hyperglycemia and dehydration and frequently appear quite ill physically. Cetoacidosis diabetica y estado hiperosmolar revision 2016. However, hhs is different and treatment requires a different approach.