TY  - JOUR
T1  - HYpovolemia in patients with hyperglycemia—reply
AU  - McGee S, Abernethy III WB
Y1  - 1999/11/10
N1  - 10-1001/pubs.JAMA-ISSN-0098-7484-282-18-jbk1110
JO  - JAMA
SP  - 1720
EP  - 1721
VL  - 282
IS  - 18
N2  - 
In Reply: We agree with Dr Matz that in patients
with hyperglycemia, the serum sodium level no longer reflects the degree of
dehydration, which would be much better assessed by the calculated effective
osmolality. None of the studies in our article used effective osmolality as
a criterion standard, although we believe few if any of the patients had hyperglycemia
as a cause of their dehydration. We also agree that it would be unwise to
treat the hyperglycemic patient with only 5% dextrose because unless the patient
has renal failure and is unable to have an osmotic diuresis, most hyperglycemic
patients also have volume depletion. Hillier et al1
recently suggested that in hyperglycemic patients, the physiologic decrease
in sodium concentration may be considerably greater than the standard correction
factor of 1.6 mmol/L of sodium per 5.6 mmol/L (100 mg/dL) of glucose.

SN  - 0098-7484
M3  - doi: 10-1001/pubs.JAMA-ISSN-0098-7484-282-18-jbk1110
UR  - http://dx.doi.org/10-1001/pubs.JAMA-ISSN-0098-7484-282-18-jbk1110
ER  -