Abstract
Summary: Obese 59 years old female patient (BMI 40 kg/m2) with type 2 diabetes mellitus, treated with combined therapy of biguanides and insulins, until now without documented specific organ complications. During prolonged biliary colic accompanied by decreased food intake, vo-miting and dehydration patient did not adjust her therapy appropriately.
Hypoglycemic coma, acute renal failure and lactate acidosis developed. Intensive therapy was initiated including continuous venovenous hemodialysis (CVVHD), yet respiratory failure developed and artificial pulmonary ventilation was inevitable; the condition was subsequently complicated by a stroke.
Due to advanced multiorgan failure the patient was referred to Anesthesiology and Resuscitation clinic. Complex therapeutic approach resulted in restoring of a spontaneous ventilation and diuresis.
Still with left hemiplegia it was possible to refer the patient to high dependency unit.