Cerebral edema during the management of diabetic ketoacidosis in an adult with new onset diabetes mellitus / Edema cerebral durante el tratamiento de la cetoacidosis diabética en un adulto con diabetes mellitus de debut
Keywords:
Cerebral edema, Diabetes ketoacidosis, ManagementAbstract
Cerebral edema associated with Diabetes Ketoacidosis (DKA) is a rare but frequently fatal complication typically occurring 4 to 12 hours after initiation of treatment, but it can develop any time during DKA management. Some risk factors for DKA-related cerebral edema have been identified. Diagnosis of this lethal condition is based in clinical grounds, mainly by deterioration of the level of consciousness and CT-brain appearance. Treatment should be focussed on prevention by minimizing all the known risk factors.
Downloads
References
1. Dillon ES, Riggs H, Dyer WW. Cerebral lesions in uncomplicated fatal diabetic acidosis. The American Journal of the Medical Sciences. 1936;192(3):360-5.
2. Levin DL. Cerebral edema in diabetic ketoacidosis. Pediatric Critical Care Medicine. 2008;9(3):320-9.
3. Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes care. 2009;32(7):1335-43.
4. Haringhuizen A, Tjan D, Grool A, Van Vugt R, Van Zante A. Fatal cerebral oedema in adult diabetic ketoacidosis. Neth J Med. 2010;68(1):35-7.
5. Glaser N, Barnett P, McCaslin I, Nelson D, Trainor J, Louie J, et al. Risk factors for cerebral edema in children with diabetic ketoacidosis. New England Journal of Medicine. 2001;344(4):264-9.
6. Silver SM, Clark EC, Schroeder BM, Sterns RH. Pathogenesis of cerebral edema after treatment of diabetic ketoacidosis. Kidney international. 1997;51(4):1237-44.
7. Troy PJ, Clark RP, Kakarala SG, Burns J, Silverman IE, Shore E. Cerebral edema during treatment of diabetic ketoacidosis in an adult with new onset diabetes. Neurocritical care. 2005;2(1):55-8.
8. Marcin JP, Glaser N, Barnett P, McCaslin I, Nelson D, Trainor J, et al. Factors associated with adverse outcomes in children with diabetic ketoacidosis-related cerebral edema. The Journal of pediatrics. 2002;141(6):793-7.
9. Edge J, Hawkins M, Winter D, Dunger D. The risk and outcome of cerebral oedema developing during diabetic ketoacidosis. Archives of disease in childhood. 2001;85(1):16-22.
10. Dunger DB, Sperling MA, Acerini CL, Bohn DJ, Daneman D, Danne TP, et al. European Society for Paediatric Endocrinology/Lawson Wilkins Pediatric Endocrine Society consensus statement on diabetic ketoacidosis in children and adolescents. Pediatrics. 2004;113(2):e133-e40.
11. Nyenwe EA, Kitabchi AE. The evolution of diabetic ketoacidosis: An update of its etiology, pathogenesis and management. Metabolism. 2016;65(4):507-21.
12. Franklin B, Liu J, Ginsberg-Fellner F. Cerebral edema and ophthalmoplegia reversed by mannitol in a new case of insulin-dependent diabetes mellitus. Pediatrics. 1982;69(1):87-90.
13. Shabbir N, Oberfield SE, Corrales R, Kairam R, Levine LS. Recovery from symptomatic brain swelling in diabetic ketoacidosis. Clinical pediatrics. 1992;31(9):570-3.
14. Roberts MD, Slover RH, Chase HP. Diabetic ketoacidosis with intracerebral complications. Pediatric diabetes. 2001;2(3):109-14.
