Maioli M, Arca G M, Ganau A, Mastroni P, Pacifico A, Padua G, Piredda G, Solinas G, Tonolo G, Ruiu P
Istituto di Clinica Medica, Università di Sassari, Italy.
Diabetes Res. 1991 Sep;18(1):45-8.
The case of a non diabetic 6-year-old boy affected by Down's syndrome, who developed hyperosmolar hyperglycemic non-ketotic coma following the infusion of hypertonic dextrose solution during general anesthesia for a surgical procedure for cryptorchidism is reported. Following surgery, the patient remained deeply comatose and generalized seizures occurred. Hyperosmolarity due to hyperglycemia and acidosis were reduced by administration of insulin at low rate, hypotonic saline and sodium-bicarbonate solutions. The patient's clinical conditions promptly improved following normalization of blood glucose levels. An oral glucose tolerance test performed three months later was normal. The authors emphasize the potential risk of hyperosmolar hyperglycemic non-ketotic coma also in non diabetic patients treated with hypertonic dextrose solutions, during surgery events.
报告了一名6岁非糖尿病唐氏综合征男孩的病例，该男孩在隐睾手术全身麻醉期间输注高渗葡萄糖溶液后发生高渗高血糖非酮症昏迷。术后，患者仍深度昏迷并出现全身性癫痫发作。通过低剂量胰岛素、低渗盐水和碳酸氢钠溶液治疗降低了高血糖和酸中毒导致的高渗状态。血糖水平恢复正常后，患者的临床状况迅速改善。三个月后进行的口服葡萄糖耐量试验正常。作者强调，在手术过程中，接受高渗葡萄糖溶液治疗的非糖尿病患者也存在高渗高血糖非酮症昏迷的潜在风险。
