Diabetic ketoacidosis accompanied by Severe hypothermia : A case report

糖尿病酮酸症中毒併重度低體溫：案例報告

黃鈺筌(Yu-Chuan Huang) ； 阮祺文(Chi-Wen Juan) ； 吳健琳(Jian-Lin Wu)

《中華職業醫學雜誌》 27卷4期 (2020/10) Pp. 309-313

摘要

We report a case of Diabetic ketoacidosis accompanied byrare complications of severe hypothermia, with development of cardiac arrest and prominent J (Osborn) waves on electrocardiography. A 27-year-old woman with a 14-year history of type 1 diabetes was admitted to hospital with disturbance of consciousness. She had a core temperature of 27.8°C and a serum glucose of show high mg/dL. Twelve-lead electrocardiography showed atrial fibrillation, prominent J (Osborn) waves, and QT prolongation (Fig. 1). She received a 10-unit bolus of regular insulin, followed by intravenous fluids and insulin infusion. Successful rewarming was achieved with an external rewarming blanket and warm intravenous fluids over 24 hours with resolutioned follow-up ECG. Patient discharged from the hospital after an 7-day admission. This case illustrates that rare complications such as hypothermia can occur in diabetic ketoacidosis, with development of cardiac arrest. Prompt recognition of severe hypothermia is critical in DKA because hypothermia may protends a poor prognosis.

關鍵字

Diabetic ketoacidosis ； hypothermia ； Osborn J waves

並列摘要

病例報告：一名有第1型糖尿病病史的27歲婦女，發生意識改變，糖尿病酮症酸中毒症，合併嚴重低體溫及院內心臟驟停止跳動。十二導聯心電圖發生明顯J（Osborn）波。經使用胰島素輸注和加溫靜脈輸液治療。體溫和酸血症情況回復，康復出院。文獻顯示低體溫的發生在糖尿病酮酸血症中毒病人並非常見情況，而此案例說明糖尿病酮症酸中毒發生低體溫併發症之臨床概況。快速識別低體溫發生情況，並給予適時治療對於預後的處置至關重要。

並列關鍵字

糖尿病酮酸中毒 ； 低體溫 ； J波