A metabolic complication of severe burns

A 32-year-old male was referred to intensive care with possible respiratory sepsis 15 days after sustaining 73 per cent TBSA electrical burns. Investigation revealed previously undiagnosed hyperosmolar non-ketotic diabetic coma. The aetiology, pathogenesis and management of this recognized complication of major burns is discussed. An interesting feature of this case is recovery from 73 per cent burns, severe hyperosmolar non-ketotic diabetic coma and a serum osmolality of 429 mosmol/kg, each of which carry a high mortality probability.