Gallo de Moraes Alice, Surani Salim
Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, United States.
Division of Pulmonary, Critical Care and Sleep Medicine, Texas A and M University, Corpus Christy, TX 78412, United States.
World J Diabetes. 2019 Jan 15;10(1):16-22. doi: 10.4239/wjd.v10.i1.16.
Diabetes affects approximately 30 million persons in the United States. Diabetes ketoacidosis is one of the most serious and acute complications of diabetes. At the time of presentation and during treatment of diabetic ketoacidosis (DKA), several metabolic and electrolyte derangements can ultimately result in respiratory compromise. Most commonly, hypokalemia, hypomagnesemia and hypophosphatemia can eventually lead to respiratory muscles failure. Furthermore, tachypnea, hyperpnea and more severely, Kussmaul breathing pattern can develop. Also, hydrostatic and non-hydrostatic pulmonary edema can occur secondary to volume shifts into the extracellular space and secondary to increased permeability of the pulmonary capillaries. The presence of respiratory failure in patients with DKA is associated with higher morbidity and mortality. Being familiar with the causes of respiratory compromise in DKA, and how to treat them, may represent better outcomes for patients with DKA.
在美国，约有3000万人受糖尿病影响。糖尿病酮症酸中毒是糖尿病最严重的急性并发症之一。在糖尿病酮症酸中毒（DKA）的就诊和治疗期间，多种代谢和电解质紊乱最终可导致呼吸功能受损。最常见的是，低钾血症、低镁血症和低磷血症最终可导致呼吸肌无力。此外，还可出现呼吸急促、呼吸深快，更严重的可出现库斯莫尔呼吸模式。另外，由于液体转移至细胞外间隙以及肺毛细血管通透性增加，可继发静水压性和非静水压性肺水肿。DKA患者出现呼吸衰竭与更高的发病率和死亡率相关。熟悉DKA呼吸功能受损的原因及其治疗方法，可能会为DKA患者带来更好的治疗结果。
