A patient with hyperglycemic hyperosmolar syndrome (HHS)has a serum glucose level of 400 mg/dL and a serum sodium level of 138 mEq/L.The intravenous fluid of choice would be

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The fluid deficit may be as much as 150 mL/kg of body weight.The average 150-lb adult can lose more than 7 to 10 L of fluid.Physiologic saline solution (0.9%)is infused at 1 L/hr, especially for patients in hypovolemic shock if there is no cardiovascular contraindication.Several liters of volume replacement may be required to achieve a blood pressure and central venous pressure within normal range.Infusion volumes are adjusted according to the patient's hydration state and sodium level.

A Patient with Hyperglycemic Hyperosmolar Syndrome (HHS)has a Serum Glucose