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Pediatric Hyperglycemic Hyperosmolar Syndrome: A Comprehensive Approach to Diagnosis, Management, and Complications Utilizing Novel Summarizing Acronyms
This paper focuses on hyperglycemic hyperosmolar syndrome (HHS), a unique hyperglycemic state requiring divergent diagnosis and treatment approaches from diabetic ketoacidosis (DKA) despite some shared characteristics. We introduce the mnemonic DI-FF-ER-EN-CE-S to encapsulate unique HHS management a...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10670661/ https://www.ncbi.nlm.nih.gov/pubmed/38002864 http://dx.doi.org/10.3390/children10111773 |
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author | Zahran, Naser Amin Jadidi, Shaheen |
author_facet | Zahran, Naser Amin Jadidi, Shaheen |
author_sort | Zahran, Naser Amin |
collection | PubMed |
description | This paper focuses on hyperglycemic hyperosmolar syndrome (HHS), a unique hyperglycemic state requiring divergent diagnosis and treatment approaches from diabetic ketoacidosis (DKA) despite some shared characteristics. We introduce the mnemonic DI-FF-ER-EN-CE-S to encapsulate unique HHS management and complications. ‘DI’ emphasizes the need to delay and decrease initial insulin therapy until serum glucose decline is managed by fluid resuscitation alone. ‘FF’ stresses the importance of double fluid replacement compared to DKA due to severe dehydration and ‘ER’ electrolyte replacement due to profound losses and imbalances. ‘EN’ denotes the potential for encephalopathy and the requirement for a controlled serum osmolality reduction. ‘CE’ indicates cerebral edema, a rare complication in HHS. ‘S’ signifies systemic multiorgan failure. We categorize the associated risks into three mnemonic groups: the 3Rs (renal failure, respiratory distress, rhabdomyolysis), the 3Hs (heart failure, hypercoagulation, hyperthermia), and AP (arrhythmias, pancreatitis) to facilitate awareness and screening of HHS. |
format | Online Article Text |
id | pubmed-10670661 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-106706612023-10-31 Pediatric Hyperglycemic Hyperosmolar Syndrome: A Comprehensive Approach to Diagnosis, Management, and Complications Utilizing Novel Summarizing Acronyms Zahran, Naser Amin Jadidi, Shaheen Children (Basel) Review This paper focuses on hyperglycemic hyperosmolar syndrome (HHS), a unique hyperglycemic state requiring divergent diagnosis and treatment approaches from diabetic ketoacidosis (DKA) despite some shared characteristics. We introduce the mnemonic DI-FF-ER-EN-CE-S to encapsulate unique HHS management and complications. ‘DI’ emphasizes the need to delay and decrease initial insulin therapy until serum glucose decline is managed by fluid resuscitation alone. ‘FF’ stresses the importance of double fluid replacement compared to DKA due to severe dehydration and ‘ER’ electrolyte replacement due to profound losses and imbalances. ‘EN’ denotes the potential for encephalopathy and the requirement for a controlled serum osmolality reduction. ‘CE’ indicates cerebral edema, a rare complication in HHS. ‘S’ signifies systemic multiorgan failure. We categorize the associated risks into three mnemonic groups: the 3Rs (renal failure, respiratory distress, rhabdomyolysis), the 3Hs (heart failure, hypercoagulation, hyperthermia), and AP (arrhythmias, pancreatitis) to facilitate awareness and screening of HHS. MDPI 2023-10-31 /pmc/articles/PMC10670661/ /pubmed/38002864 http://dx.doi.org/10.3390/children10111773 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Zahran, Naser Amin Jadidi, Shaheen Pediatric Hyperglycemic Hyperosmolar Syndrome: A Comprehensive Approach to Diagnosis, Management, and Complications Utilizing Novel Summarizing Acronyms |
title | Pediatric Hyperglycemic Hyperosmolar Syndrome: A Comprehensive Approach to Diagnosis, Management, and Complications Utilizing Novel Summarizing Acronyms |
title_full | Pediatric Hyperglycemic Hyperosmolar Syndrome: A Comprehensive Approach to Diagnosis, Management, and Complications Utilizing Novel Summarizing Acronyms |
title_fullStr | Pediatric Hyperglycemic Hyperosmolar Syndrome: A Comprehensive Approach to Diagnosis, Management, and Complications Utilizing Novel Summarizing Acronyms |
title_full_unstemmed | Pediatric Hyperglycemic Hyperosmolar Syndrome: A Comprehensive Approach to Diagnosis, Management, and Complications Utilizing Novel Summarizing Acronyms |
title_short | Pediatric Hyperglycemic Hyperosmolar Syndrome: A Comprehensive Approach to Diagnosis, Management, and Complications Utilizing Novel Summarizing Acronyms |
title_sort | pediatric hyperglycemic hyperosmolar syndrome: a comprehensive approach to diagnosis, management, and complications utilizing novel summarizing acronyms |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10670661/ https://www.ncbi.nlm.nih.gov/pubmed/38002864 http://dx.doi.org/10.3390/children10111773 |
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