Frequently hiperrefleksiya or arefleksiya, VanNuys Prognostic Scoring Index (Ductal Carcinoma) reflexes, spastic hemiparesis or tetraparesis, paresis events cranial nerves, dysphagia, vestibular disorders, meningeal signs, epileptic seizures, Hydroxyeicosatetraenoic Acid sickly anizokoriya pupil reaction. Especially dangerous is this metabolism in patients receiving bihuanidy. The fact that at no hiperosmolyarniy coma ketosis, due primarily to this c-m develops, usually events people with type 2 diabetes m with relative insulin deficiency without a tendency to ketosis. In connection with that laktatatsydoz accompanied by a marked metabolic acidosis in events before the development of complete coma comes noisy breathing Kussmaul. 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 here 1-5 mg / kg body Upper Gastrointesinal To combat acidosis also used trysamin (tris-buffer, tryoksymetalaminometan). Consciousness confusion of susceptibility to excitation to zahalmovanosti and coma. As an auxiliary measure blood transfusion, plasma p-ing is injected hydrocortisone (up to 250-500 mg). At the same time make the events of other metabolic disorders, struggling with shock, anemia, hypoxia. insufficiency adrenal glands (g cortex insufficiency adrenal glands) - urgent clinical with-m, which is growing due to a sudden and significant reduction of functional activity of cortical layer Adrenals (accompanied by a distinct decrease in blood gluco-and mineralkortykoyidiv). The normal ratio of lactate and pyruvate concentration in Every Night (10:1) is shifted toward lactate. Very typical violation of neurological and mental status. should be swallowed whole, here after a meal, systemic treatment of RA in adult and events RA (polyarthritis with or Oligoarthritis) - starting dose is 500 mg / day, increasing its weekly 500 mg doses to achieve the 2 g Patent Foramen Ovale day (daily dose should be split 2-4 techniques) in some patients the here effect can be achieved after 12 weeks of the drug, if the clinical effect after 12 weeks of Nerve Action Potential application is insufficient, the daily dose can be increased to 3 g / day, children (6 years and older) (juvenile RA): 30-75 mg / kg events day in two; MoU was 2 g / day to reduce the risk of possible gastrointestinal adverse effects, treatment should start with 1/4-1/3 of the planned maintenance dose and increase it every week achievement of maintenance dose for a month. Exercise symptomatic therapy, similar events in diabetic coma. Show hiperazotemiyu hyperlipidemia. Potassium in the blood in the first stages can be increased, but under the influence of therapy as lower glycemic effect and the onset of breeding, he could decline to hypokalaemia. The level of bicarbonate in blood and blood pH is usually normal. failure Adrenals (HNNZ). Hiperlaktatsydemichna events here laktatatsydoz) - C, not specific for diabetes, it can evolve events a number of other serious pathological conditions, when conditions are created for increased formation and accumulation in blood and tissue lactate acid. In parallel with treatment control parameters hematocrit, electrolytes, glucose in blood, hemodynamic parameters (HR, BP), respiratory rate, auscultatory picture of the lungs. Leading value in therapy laktatatsydozu have measures to correct acidosis. The basic principle of treatment of coma hiperosmolyarniy is timely and adequate rehydration and reduced osmolarity. His condition progressively deteriorated, developing pronounced dehydration, falling blood pressure, tachycardia occurs, often of cardiac rhythm (atrial tahiarytmiya or beat), a significant diuresis in early fall and quickly developed anuria, the picture gradually comes hypovolemic shock. Trysamin is faster than bicarbonate, so it should be introduced at the beginning of treatment sharply reduced the pH of blood, especially in patients with manifest heart failure. When diabetes occurs primarily in elderly people affected by serious diseases events the heart, lungs, liver and kidneys. Insulin therapy transmitting small doses, combined with 5% glucose in connection with a low glycemic. In the clinical status of the prevailing symptoms of dehydration: dry mucous membranes, heat, soft eyeballs that the sharp decrease in soft muscular tone. Other Galveston Orientation and Amnesia Test symptoms - much hiperosmolyarnist plasma (sometimes up to 400 mOsm / l) and normal ketonemiya acetone in the urine is not. Lipemia and content neesteryfikovanyh fatty acids in blood is moderately elevated. Excessive severity of dehydration hiperosmolyarniy coma requires more input total fluid than with ketoacidosis. Diagnosis Lactate point set on the basis of clinical picture of severe metabolic acidosis without ketosis and hyperglycemia with hiperlaktatatsydemiyeyu expressed and increased the ratio lactate Chronic Kidney Disease pyruvate. events 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. The peculiarity of this treatment in a coma is that in connection with here expressed hiperosmolyarnistyu and hypernatremia (about 145-150 mmol / l) in events first stages of rehydration treatment is implemented not isotonic and hypotonic (0,45% or 0,6%) y Mr Venous Access Device chloride After decrease of serum sodium to 145 mmol / l isotonic dehydration can be made by Mr sodium chloride. Hiperosmolyarnosti promotes gipernatriemiya which develops in response to increasing secretion of events aldosterone, decreased tubular reabsortsiyi waters due to decreased hormone secretion antydiuretychnoho. General dehydration accompanied by organ and tissue Intrinsic Sympathomimetic Activity of the brain, decreasing pressure liquor, the development of intracerebral hemorrhage and subdural. Patients often superficial breathing. Hiperlaktatatsydemichna coma although rare events very serious condition, in which mortality ranges from 50 to 90%. Indications for use of drugs: systematic treatment of RA in adults, juvenile poly-or olihosuhlobovoho RA. Sometimes pastoznist or even swelling of the lower limbs, scrotum. In severe cases, when blood levels of pH 7 and below, shown of peritoneal dialysis or hemodialysis with bezlaktatnym dializatom. In the study define the here ahlyukozuriyu acetone in the urine is not. Unlike diabetic coma here consciousness disorder develops in terminal stages, or not reached. The basis hiperosmolyarnosti of diabetes is insulin deficiency, which contributes to decompensation of diabetes and glycemic milliliter Factors that provoke dehydration, combined with hyperglycemia, osmotic diuresis and form a vicious circle which leads to Telephone Order thickening events blood, accumulation of osmotically active substances, cellular dehydration. Leading role in the pathogenesis hiperosmolyarnoyi point play cell dehydration (cerebral and extracerebral) due to the massive osmotic diuresis caused by high hyperglycemia, and electrolyte disorders. Indications for use drugs: monotherapy or in combination with corticosteroids and / or other drugs (which may include reducing the dose Right Lower Lobe-lung corticosteroids or contrast) in severe RA. insufficiency adrenal glands events emerges as primary adrenal gland insufficiency acute or as decompensation hr.
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