Hyperosmolar state acid-base status?

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Hyperosmolar state acid-base status?

In a hyperosmolar state such as hyperosmolar hyperglycemic state, severe hyperglycemia plus dehydration drives osmotic diuresis, but enough insulin remains to suppress lipolysis and ketogenesis. With minimal ketone production, there isn’t the ketoacidosis that would lower the pH. So the acid-base status stays essentially normal, with pH typically in the normal range and bicarbonate not significantly depleted. If there were significant lactate from poor perfusion, a mild acidemia could occur, but that’s not the defining feature of the hyperosmolar state.

In a hyperosmolar state such as hyperosmolar hyperglycemic state, severe hyperglycemia plus dehydration drives osmotic diuresis, but enough insulin remains to suppress lipolysis and ketogenesis. With minimal ketone production, there isn’t the ketoacidosis that would lower the pH. So the acid-base status stays essentially normal, with pH typically in the normal range and bicarbonate not significantly depleted. If there were significant lactate from poor perfusion, a mild acidemia could occur, but that’s not the defining feature of the hyperosmolar state.

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