Hyperglycemic Hyperosmolar State

Elderly pts with DM, usually type II

Debilitated pts who cannot care for themselves

Chronically ill diabetic pts who experience exacerbation of an underlying comorbidity

Incidence increased in African Americans, Hispanics, and Native Americans

Severe hypovolemia and hemodynamic instability

Presence of diffuse organ system damage from poor glycemic control

Altered mental status and increased risk of pulmon aspiration

Periop stress causing further elevations in serum glucose

Cause of hyperglycemic hyperosmolar state.

Volume status and potential hemodynamic instability.

Electrolyte and acid-base abnormalities increase the risk of cardiac arrhythmias.

Serious metabolic condition characterized by hyperglycemia, hyperosmolarity, and dehydration

Is one of several potentially fatal states associated with poorly controlled DM

Requires aggressive treatment and close electrolyte and hemodynamic monitoring