INSULIN SHOCK TREATMENT
Abstract
1. A case of acute pulmonary edema occurring during insulin hypoglycemic coma and ending in death five days later from pulmonary gangrene is presented.
2. The acute pulmonary edema may have resulted from:
(a) Hyperadrenalinemia with left ventricular failure.
(b) Disturbance of vasomotor control of the pulmonary vessels centrally or peripherally (neuropathic pulmonary edema).
(c) The shock syndrome.
3. Pulmonary gangrene probably resulted from aspiration of infected material and a fulminating anaerobic infection superimposed upon a subclinical bronchiectasis.
4. Injections of adrenalin during the course of insulin shock therapy is probably inadvisable.
5. Bronchiectasis should be considered a contraindication to insulin shock therapy.
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