Les syndromes hyperosmolaires [a propos de 31 cas]

ABSTRACT

The hyperosmolar syndrome observed in the middle intensive care with a non negligible frequence, it occurs usually during serious diseases. In this from worth, the authors brought 21 observed cases during a three year activity in an intensive medical care service which doesn't arrive from a special diabetic recruitement. This series consists of eleven cases of hypero smolar hyperglycemic non ketotic syndrome and which accounts in this class four cases of diabetes and four cases due to drugs. Ten cases are hyperosmolar syndrome with a minor disorder of the glycoregulation where hypernatremic which had originally a neurogenic cause in the three cases, a hydric negative balance for diverse reasons in five of the cases, an iatrogenic cause in two of the cases. The clinical aspect at admissions is severe consisting of a shock and a coma in half of the cases, the biological aspect is stereotyped hypernatremia, hyperglycemia [important in eleven Cases], functional renal failure. There is neither metabolic, acidosis nor major ketonuria. The prognosis remains serious with a mortality rate of 25% where there intervens such. prognostic factors as advanced, the field and the sepsis, in the series one notes besides a diagnostic delay specially de 13.6 days on the average