DKA and HHS Review: Potassium, Insulin and Ketones | Part 2 | 血糖急症 | OET Music

Dr Allison Lu · Pip & Barnaby · Medical English

本頁提供本曲完整英文歌詞與影片搭配的繁中醫學提示。歌詞保留原演唱文字；遇到過度簡化或舊門檻，請搭配下方提示與原始資料閱讀。這是概念學習材料，不替代個別醫療評估。

Lyrics · 完整歌詞

The central distinctions can be recalled as follows.

All ketoacidosis is high anion gap metabolic acidosis with Kussmaul compensation,
defined by pH below 7.3, bicarbonate below 18 and positive ketones.
Is the potassium below 3.3 mmol/L?
Replace it first and withhold insulin,
because the serum value hides a total-body deficit.
On glucose falling below 14 mmol/L,
dextrose is added and the insulin continues until the ketones,
not the sugar, have cleared.
Lumen of the collecting duct overflowing with glucose defines the hyperosmolar state:
glucose above 33, osmolality above 320, pH above 7.3.


All ketoacidosis is high anion gap metabolic acidosis with Kussmaul compensation,
defined by pH below 7.3, bicarbonate below 18 and positive ketones.
Is the potassium below 3.3 mmol/L?
Replace it first and withhold insulin,
because the serum value hides a total-body deficit.
On glucose falling below 14 mmol/L,
dextrose is added and the insulin continues until the ketones,
not the sugar, have cleared.
Lumen of the collecting duct overflowing with glucose defines the hyperosmolar state:
glucose above 33, osmolality above 320, pH above 7.3.

Medical Notes · 醫學學習提示

  1. 回顧成人酮酸與高滲急症；中文提示補正舊版唱詞
  2. 常見高間隙酸中毒；呼吸代償程度與混合失衡須評估
  3. pH <7.3 或 HCO3 <18；另須酮血症及糖尿病／高血糖
  4. 更新：成人血鉀 <3.5 mmol/L 即須先補鉀
  5. 血鉀升至 >3.5 再給胰島素；依監測與院內流程
  6. 血鉀可能正常或偏高，但全身儲量仍不足
  7. 成人 DKA 血糖 <13.9 mmol/L 時加入葡萄糖
  8. 胰島素持續清酮；必要時調低速率並加葡萄糖
  9. 血酮 <0.6，且 pH ≥7.3 或 HCO3 ≥18 才達緩解
  10. HHS 非以糖尿定義；須高血糖、高滲且無明顯酮酸中毒
  11. 成人：血糖 ≥33.3；有效滲透壓 >300 或總滲透壓 >320

References