HHS Clinical Presentation
Most patients present with global or focal neurologic symptoms as well as severe dehydration. HHS, previously termed hyperosmolar hyperglycemic nonketotic coma (HHNC), was changed in terminology because 20% or less presented with coma definitions.
Diagnostic features of HHS may include the following:
- Some alteration in consciousness;
- Plasma glucose level of 600 mg/dL or greater;
- Effective serum osmolality of 320 mOsm/kg or greater;
- Serum pH greater than 7.30;
- Profound dehydration up to an average of 9L;
- Small ketonuria and absent-to-low ketonemia;
- Bicarbonate concentration greater than 15 mEq/L;
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