DM
Diabetic Ketoacidosis Related Cerebral Edema
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Diabetic Ketoacidosis Related Cerebral Edema
, DKA related Cerebral Edema
See Also
Diabetic Ketoacidosis
Diabetic Ketoacidosis Management in Adults
Diabetic Ketoacidosis Management in Children
Epidemiology
Incidence
: 0.5 to 1% of
Diabetic Ketoacidosis
patients
Risk Factors
Younger children (<5 years old) with new onset of diabetes and longer duration of symptoms
Severe acidosis
Rapid hydration has been postulated as cause
Precautions regarding fluid rate and amount are standard of care in
Diabetic Ketoacidosis
management (see below)
However large study did not show an association with fluid rate or amount
Glaser (2001) N Engl J Med 344(4): 264-9 [PubMed]
Symptoms
Initial Symptoms
Headache
Refractory
Vomiting
Hypertension
Bradycardia
Lethargy
Precautions
Children under age 5 years old with DKA
Avoid large fluid boluses beyond initial 10-20 cc/kg if at all possible
Avoid dropping
Serum Osmolality
(calc) >3 mOsms/hour
Management
See
Diabetic Ketoacidosis Management in Adults
See
Diabetic Ketoacidosis Management in Children
Prognosis
Mortality: 21-24% (50% in some studies)
Persistent vegatative state in up to one third of surviving children
References
Aurora and Menchine in Herbert (2014) EM:Rap 14(1): 10-11
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