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Lookup NU author(s): Professor Peter Baylis
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Aims/hypothesis. To test the hypothesis that subnormal thirst sensation could contribute to the development of the hypernatraemia characteristic of hyperosmolar coma, we studied osmoregulation in survivors of hyperosmolar coma. Methods. Eight survivors of hyperosmolar coma, eight control subjects with Type II (non-insulin-dependent) diabetes mellitus and eight healthy control subjects underwent water deprivation during which measurements of thirst, plasma osmolality and vasopressin were taken. Results. Water deprivation caused greater peak plasma osmolality in the hyperosmolar coma group (301.7 +/- 2.7 mmol/kg) than in Type II diabetic (294.3 +/- 3.2 mmol/kg, p < 0.01) or control group (296.9 +/- 3.0 mmol/kg, p < 0.01) and a greater increase in plasma vasopressin concentration (hyperosmolar coma, 5.8 +/- 1.3 pmol/l, Type II diabetes, 1.8 +/- 1.3 pmol/l, p < 0.001, control subjects, 2.2 +/- 1.8 pmol/l, p < 0.001). Thirst ratings were lower following water deprivation in the hyperosmolar coma group (3.5 +/- 0.8 cm) than in Type II diabetes (7.7 +/- 1.6 cm, p < 0.001) or control subjects (7.4 +/- 1.3 cm, p < 0.001), and the hyperosmolar group patients drank less in 30 min following water deprivation (401 +/- 105 mi) than Type II diabetic (856 +/- 218 mi, p < 0.001) or control subjects (789 +/- 213 mi, p < 0.001). Conclusion/interpretation. Survivors of hyperosmolar coma have subnormal osmoregulated thirst and fluid intake, which might contribute to the hypernatraemic dehydration typical of the condition.
Author(s): Baylis PH; McKenna K; Morris AD; Azam H; Newton RW; Thompson CJ
Publication type: Article
Publication status: Published
Journal: Diabetologia
Year: 1999
Volume: 42
Issue: 5
Pages: 534-538
Print publication date: 19/04/1999
ISSN (print): 0012-186X
ISSN (electronic): 1432-0428
Publisher: Springer
URL: http://dx.doi.org/10.1007/s001250051191
DOI: 10.1007/s001250051191
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