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Diabetic ketoacidosis with intracerebral complications
Author(s) -
Roberts Mary Dunne,
Slover Robert H,
Chase H Peter
Publication year - 2001
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1034/j.1399-5448.2001.002003109.x
Subject(s) - medicine , diabetic ketoacidosis , ketoacidosis , intensive care medicine , diabetes mellitus , medline , pediatrics , type 1 diabetes , endocrinology , political science , law
Purpose: To describe 11 instances of severe diabetic ketoacidosis (DKA) with secondary intracerebral complications (ICCs), nine of whom were treated early and showed complete recovery. Methods: Three hundred and eighty‐one episodes of DKA were treated at Denver Children's Hospital (DCH) from January 1989 to December 1999. Nine instances of DKA with ICC were prospectively identified during this time period. Two additional occurrences were identified via a medical records search (total incidence, 2.9%). The signs, symptoms and laboratory values which led to their diagnosis and treatment are identified. Results: All nine children who received early treatment with i.v. mannitol showed complete recovery. An additional patient had central nervous system involvement upon arrival at our hospital and showed almost complete recovery. Another patient suffered a cardiorespiratory arrest before transfer to our hospital and died without being treated for cerebral edema. Conclusion: Prevention of ICCs by the earlier diagnosis of diabetes and by being aware of possible risk factors for cerebral edema is the eventual goal. Based on our experience, mannitol should be given promptly for the treatment of ICCs indicated by the clinical course even if cerebral edema is not documented by a computed tomography (CT) scan.