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616.379-008.64-02-07 (1) |
Patologia sistemului digestiv. Tulburări ale tubului alimentar (1698) |
SM ISO690:2012 GÎRBU, Lucia, GREJDIERU, Alexandra, COJOCARU, Victor, GRIB, Liviu, CAZACU, Gheorghe, BIVOL, Elena. Diabetul zaharat primar depistat, complicat cu cetoacidoză. Caz clinic. In: Sănătate Publică, Economie şi Management în Medicină , 2016, nr. 2(66), pp. 170-173. ISSN 1729-8687. |
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Sănătate Publică, Economie şi Management în Medicină | |||||
Numărul 2(66) / 2016 / ISSN 1729-8687 /ISSNe 2587-3873 | |||||
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CZU: 616.379-008.64-02-07 | |||||
Pag. 170-173 | |||||
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Ketoacidosis is a metabolic complication of the Diabetes Mellitus, that appears frequently in the Diabetes type 1, and much more rarely in diabetes 2. The patient, whose case is described represents clinical role of a severe ketoacidosis: weight loss, signs of deshydratation and hypovolemia, Kussmaul breathing, confusion, laboratory abnormalities (metabolic acidosis with pH 6,68 and bicarbonat 1 mmoli/l). Ketoacidosis was shown as an onset of diabetes. This situation required prompt diagnosis and appropriate intensive treatment. Therapeutic course, involves: rebalancing the volume and restoring the capital fluid, correction of dyselectrolytemia, correction of hyperglycemia and ketoacidosis and hyperosmolarity of the serum. Central vascular and hemodynamic monitoring approach was dictated by the degree of hypovolemia, cardiovascular status and pathology of the patient. The correction of hypokalemia was performed before starting the insulin infusion. Bicarbonate administration, continuous intravenous insulin therapy was targeted towards normalization of the anionic hole. Following the principles discussed, in approaching the diagnosis and intensive treatment of diabetic ketoacidosis, patient progress was favorable. |
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Cuvinte-cheie diabetes mellitus, ketoacidosis, hypovolemia, dehydration, anionic gap |
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