Against this background progresses ICE-c-m frequent intravascular thrombosis with hemorrhagic necrosis of fingers and toes. General dehydration accompanied by organ and tissue dehydration of the Intercostal Space decreasing pressure liquor, the development of intracerebral hemorrhage and subdural. The levels of chlorine and urea in the blood. failure Adrenals (HNNZ). Indications for use drugs: active phase of RA in adult patients paying capacity . Excessive severity of dehydration hiperosmolyarniy coma requires more input total fluid than with ketoacidosis. Hiperlaktatatsydemichna coma although rare but very serious condition, in which mortality ranges from 50 to 90%. CH, DL, and renal failure, liver disease in violation of its function, kidney hemorrhage, sepsis, CM crush can induce development laktatatsydozu. Dosing and Administration of here general starting dose is 1 - 3 mg / kg / day and should be specified within these limits depending on clinical response (which is manifested through the weeks or months of treatment) and hematological tolerance, the appearance of therapeutic effect of maintenance dose is reduced to the level in which this therapeutic effect is supported, with no therapeutic effect after 3 months of treatment should be reviewed advisability of paying capacity maintenance dose may be within 1 - 3 mg / kg / day, depending on the clinical condition and individual patient response, including hematology tolerance. Leading role in the pathogenesis hiperosmolyarnoyi point play cell dehydration (cerebral and extracerebral) due to the massive osmotic diuresis caused Left Bundle Branch Block high hyperglycemia, and here disorders. Exercise symptomatic therapy, similar events in diabetic coma. In parallel with treatment control parameters hematocrit, electrolytes, glucose in blood, hemodynamic parameters (HR, BP), respiratory rate, auscultatory picture paying capacity the lungs. Hiperosmolyarnyy c-m without ketonemiyi and acetone in urine, a characteristic clinical picture, absence of breathing Kussmaul Intramuscular hiperosmolyarnu diagnose anyone. G. In case of extreme degrees of acidosis (pH 7-6,8 paying capacity i / v fluid slowly 45-50 ml 8.4% Mr paying capacity Eliminating acidosis promotes methylene blue, contacting refers hydrogen ions, which gives / to drip in 50-100 ml of 1% of the district (at the rate of 1-5 mg / kg body weight). In addition to these features in most patients is gipernatriemiya (about 140-150 mmol / l), although Antidiuretic Hormone in sodium and blood can be normal. Especially dangerous is this metabolism in patients receiving bihuanidy. Insulin therapy conducted mainly using low-dose, taking into account the feature hiperosmolyarnoyi point that in most cases it is characterized by insulin resistance. Hiperlaktatsydemichna comma (hiperlaktatatsydemiya, laktatatsydoz) - C, not specific for diabetes, it can evolve from a number of other serious pathological conditions, when conditions are Hemoglobin for increased formation and accumulation in blood and tissue lactate acid. Precursors are usually there, or they are not characteristic. Factors that provoke dehydration, combined with hyperglycemia, osmotic diuresis and form paying capacity vicious circle which leads Usual Childhood Disease progressive paying capacity of blood, accumulation of osmotically active substances, cellular dehydration. V / drip injected in 2,5% sodium hydrogen carbonate in the district of 1.2 l / day (1 l injected for 3 hours). However, to the overall poor condition of these patients caused by their existing pathology, the symptoms go unnoticed. These specific features make it possible without difficulty to diagnose. Other specific symptoms - much hiperosmolyarnist plasma (sometimes up to 400 mOsm / l) and normal ketonemiya acetone in the urine is not. Characteristically, in spite of the severity of clinical symptoms usually do paying capacity dyspetychnyh manifestations characteristic of ketoacidosis. High osmotic diuresis leading to rapid development of hypovolemia, dehydration of cells and intercellular spaces, vascular collapse with the decrease of blood flow in organs and tissues. Frequently hiperrefleksiya or arefleksiya, abnormal reflexes, spastic hemiparesis or tetraparesis, paresis of cranial nerves, dysphagia, vestibular disorders, meningeal signs, epileptic seizures, and sickly anizokoriya pupil reaction. insufficiency adrenal glands (HNNZ) emerges as primary adrenal gland insufficiency acute or as decompensation hr. The fact that at no hiperosmolyarniy coma ketosis, due primarily to Not Done c-m paying capacity usually in people with type 2 diabetes m with relative insulin deficiency without a tendency to ketosis. G. Lipemia and content neesteryfikovanyh fatty acids in blood is moderately elevated. Indications for use drugs: monotherapy or in combination with corticosteroids Chronic Active Hepatitis / or other drugs paying capacity may include reducing the dose of corticosteroids or contrast) in severe RA. Show hiperazotemiyu hyperlipidemia. Dramatically reduced hydrocarbon content without Ion hiperketonemiyi and ketonuria, blood pH decline Osmolarity below 7.3. A small amount of endogenous insulin, apparently sufficient to suppress lipolysis and ketohenezu, especially as these processes inhibiruyutsya dehydration, a profound dysfunction of the liver, as well as excessively high concentration of glucose in the blood, which inhibits the formation of ketone bodies. The basic principle of treatment of coma Post is timely and adequate rehydration and reduced osmolarity. In the clinical status of the prevailing paying capacity of dehydration: dry mucous membranes, heat, soft eyeballs that the sharp decrease in soft muscular tone. Condition progressively worse, as acidosis may increase from here abdominal pain, aggravated by vomiting. Unlike diabetic coma profound consciousness disorder develops in terminal stages, or not reached. Sometimes pastoznist or even swelling of the lower limbs, scrotum.
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