This Article  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Paul M. Beigelman, MD; Helen E. Martin, MD
University of Southern California Los Angeles

JAMA. 1970;212(10):1706.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

This reply is in answer to the letter of Clifford W. Zwillich, MD (211:829, 1970). (1) While recognizing the problem of hyperosmolality in untreated diabetic "coma," we feel early correction of acidosis and decreased extracellular fluid volume have priority and are best accomplished with the bicarbonate saline mixture recommended in our treatment schedule. It was indicated, also, that hypotonic saline solution, 0.45% sodium chloride, may be given as early as the second liter of fluid. (2) The following points are made concerning potassium therapy in the presence of azotemia. The azotemia seen in diabetic "coma" is usually of the prerenal type subsequent to osmotic diuresis with resulting severe fluid loss and decreased renal function. This usually causes a rise in serum potassium level. Acidosis, also, usually causes a rise in serum potassium level due to the shift of potassium from the intracellular to the extracellular space . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?