Monitoring
Successful treatment requires frequent monitoring of clinical and laboratory parameters to achieve resolution criteria. Glucose measurement should be repeated every 1-2 hours, and serum potassium measured every 2 hours, then every 4 hours during treatment. Serum electrolytes, blood urea nitrogen (BUN), and creatinine should be repeated every 2-4 hours, depending on the patient's clinical condition and response to therapy.
A flow sheet classifying these findings as well as mental status, vital signs, insulin dose, fluid and electrolyte therapies, and urine output enables easy analysis of response to therapy and resolution of crises.[8]
Criteria for resolution of hyperosmolar hyperglycemic state include blood glucose is <250 mg/dL, measured or calculated serum osmolality falls to <300 mOsm/kg, urine output is >0.5 mL/kg/hour, and cognitive status has improved.[1]
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