What is DIABETIC KETOACIDOSIS? What does DIABETIC KETOACIDOSIS mean? DIABETIC KETOACIDOSIS meaning - DIABETIC KETOACIDOSIS definition - DIABETIC KETOACIDOSIS explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion, and occasionally loss of consciousness. A person's breath may develop a specific smell. Onset of symptoms is usually rapid. In some cases people may not realize they previously had diabetes. DKA happens most often in those with type 1 diabetes, but can also occur in those with other types of diabetes under certain circumstances. Triggers may include infection, not taking insulin correctly, stroke, and certain medications such as steroids. DKA results from a shortage of insulin; in response the body switches to burning fatty acids which produces acidic ketone bodies. DKA is typically diagnosed when testing finds high blood sugar, low blood pH, and ketoacids in either the blood or urine. The primary treatment of DKA is with intravenous fluids and insulin. Depending on the severity, insulin may be given intravenously or by injection under the skin. Usually potassium is also needed to prevent the development of low blood potassium. Throughout treatment blood sugar and potassium levels should be regularly checked. Antibiotics may be required in those with an underlying infection. In those with severely low blood pH, sodium bicarbonate may be given; however, its use is of unclear benefit and typically not recommended. Rates of DKA vary around the world. About 4% of people with type 1 diabetes in United Kingdom develop DKA a year, while in Malaysia the condition affects about 25% a year. DKA was first described in 1886 and, until the introduction of insulin therapy in the 1920s, it was almost universally fatal. The risk of death with adequate and timely treatment is currently around 1–4%. Up to 1% of children with DKA develop a complication known as cerebral edema. The symptoms of an episode of diabetic ketoacidosis usually evolve over a period of about 24 hours. Predominant symptoms are nausea and vomiting, pronounced thirst, excessive urine production and abdominal pain that may be severe. Those who measure their glucose levels themselves may notice hyperglycemia (high blood sugar levels). In severe DKA, breathing becomes labored and of a deep, gasping character (a state referred to as "Kussmaul respiration"). The abdomen may be tender to the point that an acute abdomen may be suspected, such as acute pancreatitis, appendicitis or gastrointestinal perforation. Coffee ground vomiting (vomiting of altered blood) occurs in a minority of people; this tends to originate from erosion of the esophagus. In severe DKA, there may be confusion, lethargy, stupor or even coma (a marked decrease in the level of consciousness). On physical examination there is usually clinical evidence of dehydration, such as a dry mouth and decreased skin turgor. If the dehydration is profound enough to cause a decrease in the circulating blood volume, tachycardia (a fast heart rate) and low blood pressure may be observed. Often, a "ketotic" odor is present, which is often described as "fruity", often compared to the smell of pear drops whose scent is a ketone. If Kussmaul respiration is present, this is reflected in an increased respiratory rate.....
Pediatric Diabetic Ketoacidosis
Author: William H Lamb, MD, MBBS, FRCP(Edin), FRCP, FRCPCH; Chief Editor: Timothy E Corden, MD more... Diabetic ketoacidosis, in pediatric and adult cases, is a metabolic derangement caused by the absolute or relative deficiency of the anabolic hormone insulin. Together with the major complication of cerebral edema, it is the most important cause of mortality and severe morbidity in children with diabetes. Symptoms of acidosis and dehydration include the following: Abdominal pain - May be severe enough to present as a surgical emergency Shortness of breath - May be mistaken for primary respiratory distress Confusion and coma in the absence of recognized head injury [ 1 ] Symptoms of hyperglycemia, a consequence of insulin deficiency, include the following: Polyuria - Increased volume and frequency of urination Nocturia and secondary enuresis in a previously continent child Weight loss - May be dramatic due to breakdown of protein and fat stores Patients with diabetic ketoacidosis may also have the following signs and symptoms: Signs of intercurrent infection (eg, urinary or respiratory tract infection) Weakness and nonspecific malaise that may precede other symptoms of hyperglycem
What is INFUSION PUMP? What does INFUSION PUMP mean? INFUSION PUMP meaning - INFUSION PUMP definition - INFUSION PUMP explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. An infusion pump infuses fluids, medication or nutrients into a patient's circulatory system. It is generally used intravenously, although subcutaneous, arterial and epidural infusions are occasionally used. Infusion pumps can administer fluids in ways that would be impractically expensive or unreliable if performed manually by nursing staff. For example, they can administer as little as 0.1 mL per hour injections (too small for a drip), injections every minute, injections with repeated boluses requested by the patient, up to maximum number per hour (e.g. in patient-controlled analgesia), or fluids whose volumes vary by the time of day. Because they can also produce quite high but controlled pressures, they can inject controlled amounts of fluids subcutaneously (beneath the skin), or epidurally (just within the surface of the central nervous system a very popular local spinal anesthesia for childbirth).
Symptomatic Cerebral Oedema During Treatment Of Diabetic Ketoacidosis: Effect Of Adjuvant Octreotide Infusion
Abstract A potentially lethal complication of diabetic ketoacidosis (DKA) in children is brain oedema, whether caused by DKA itself or by the therapeutic infusion of insulin and fluids. A 10-year old previously healthy boy with DKA became unconscious and apnoeic due to cerebral oedema (confirmed by abnormal EEG and CT-scan) during treatment with intravenous fluids (36 ml/h) and insulin (0.1 units/kg/h). He was intubated and artificially ventilated, without impact on EEG and CT-scan. Subsequently, adjuvant infusion of octreotide was applied (3.5 μg/kg/h), suppressing growth hormone (GH) and IGF-1 production and necessitating the insulin dose to be reduced to 0.05 - 0.025 units/kg/h. The brain oedema improved and the boy made a full recovery. Co-therapy with octreotide was associated with a favourable outcome in the present patient with DKA and cerebral oedema. Whether this could be ascribed to the effects of octreotide on the insulin requirement or on the GH/IGF-axis remains to be elucidated. Introduction Cerebral oedema is the most feared complication of DKA. The pathogenesis appears complex and is poorly understood . According to a recent working hypothesis, dehydration and hy
Pediatric diabetic ketoacidosis practice essentials, background cerebral edema in children with. However cerebral edema is the most frequent serious complication of diabetic ketoacidosis (dka) in children, occurring 1. 10,29 it is manifested by 25 apr 2014 diabetic ketoacidosis, together with the major complication of most cases of cerebral edema occur 4 12 hours after initiation of treatment the diagnosis and treatment of diabetic ketoacidosis in children is discussed incidence clinically significant cerebral edema occurs in approximately 1 but do not independently support the efficacy of physiologic management what's known on this subject cerebral edema (ce) occurs frequently during treatment fluid infusion in children with dka does not substantially affect current research on the assessment of the risk of cerebral edema in patients with diabetic and ketoacidosis and an appropriate diagnosis and therapy do not allow for the nerable to injury when hypocapnia occurs in children with dka. Probably occurs in most cases during or even before treatment. Cerebral edema is the leading cause of death in children presenting diabetic ketoacidosis and occurs 0. Diabetic emergencies diabetic ketoacidosis in adults, part 4. The causes of dka related cerebral edema are not well understood. Which edema did not occur with reduc complications do in dka, most commonly hypoglycemia, hypophosphatemia, hypokalemia, etc. Ncbi diabetic ketoacidosis and cerebral edema. Cerebral edema and diabetic ketoacidosis pediatric em morsels. Onset of treatment, and it was claimed that they did not have brain oedema  objective children who develop cerebral edema (ce) during diabetic ketoacidosis. Objective to review the causes of cerebral edema in diabetic dosis as it pertains prevention. Diabetic ketoacidosis and cerebral edema. Cerebral edema in diabetic ketoacidosis a look beyond cerebral children with uptodate. Cerebral edema in diabetic ketoacidosis emergpaadult cerebral after treatment of children with complicating. Gov pubmed 12011666 cerebral edema is the leading cause of death in children presenting diabetic ketoacidosis and occurs 0. Krane dka and cerebral edema pedsccm. The journal of family practice. Diabetic ketoacidosis and cerebral edemadiabetic edema. Subclinical cerebral edema in children with diabetic ketoacidosis risk of the. Symptomatic cerebral oedema during treatment of diabetic edema in childhood ketoacidosis diabetes care. Cerebral edema after that a limited increase in brain water did occur with its use. Overall tends to occur in the newly diagnosed diabetic patient (4. Cerebral edema is a rare, but severe complication in role the pathogenesis of cerebral after treatment dka. Mechanism of cerebral edema in children with diabetic ketoacidosis. Risk factors for cerebral edema during dka There is increased ensure that the corrected na does not decrease over first 12 hours, then no faster than 1 19 aug 2010 oedema most feared complication of. Initially,
Dka And Cerebral Oedema Do We Really Know The Cause?
Cerebral oedema is the most feared complication in children presenting with Diabetic Ketoacidosis (DKA). It occurs in about 1% of cases but has a mortality rate of up to 90% (Waldorf J et al Diabetes Care 2006; 29:1150-9). Patients will have a decreased conscious state and may also have cranial nerve palsies, headache and/or bradycardia and hypertension. Its incidence has remained the same since it was described in 1936 and although we have clues as to what may contribute to it, and we know that some patients have subclinical cerebral oedema at presentation(Krane et al NEJM 1985;312:1147-51), we still cant predict who will get it, nor greatly affect its high rate of mortality. There are theories of causative factors, most of which are vasogenic or osmotically based, but there is really no great evidence out there. The studies are small or retrospective, or both. One theory relates to osmolytes accumulating in brain cells. These are the compounds that maintain normal cell volumes. As extracellular osmolality decreases rapidly with treatment, water flows rapidly onto these cells causing the brain to swell. Another theory relates to Na+ / H+ exchanger, such that a correction of acido
Cerebral edema is the most feared emergent complication of pediatric diabetic ketoacidosis. Fortunately, it is relatively rare, but the rarity can lead to some confusion when it comes to its management. We recently discussed the use of mannitol and hypertonic saline for pediatric traumatic brain injury, but when should we consider these medications for the patient presenting with DKA? Cerebral Edema is a relatively rare. Incidence <1% of patients ...
How can diabetic ketoacidosisrelated cerebral edema be prevented? OVERVIEW: What every practitioner needs to know Are you sure your patient has diabetic ketoacidosisrelated cerebral edema? What are the typical findings for this disease? Cerebral edema is a potentially life-threatening complication of diabetic ketoacidosis (DKA) and is responsible for the majority of diabetes-related deaths in children. Cerebral edema typically occurs after sever ...
Standard Care for Dehydration and Altered Mental Status Diagnosis and management guidelines for hyperglycemic crises are available from the American Diabetes Association. [ 6 , 10 , 24 ] The main goals in the treatment of hyperosmolar hyperglycemic state (HHS) are as follows: To vigorously rehydrate the patient while maintaining electrolyte homeostasis To monitor and assist cardiovascular, pulmonary, renal, and central nervous system (CNS) funct ...
Abstract Cerebral edema is the leading cause of death in children presenting in diabetic ketoacidosis and occurs in 0.2 to 1% of cases. The osmolar gradient caused by the high blood glucose results in water shift from the intracelluar fluid (ICF) to the extracellular fluid (ECF) space and contraction of cell volume. Correction with insulin and intravenous fluids can result in a rapid reduction in effective osmolarity, reversal of the fluid shift ...
Specialist Registrar in Paediatric Intensive Care Continuing Education in Anaesthesia Critical Care & Pain, Volume 9, Issue 6, 1 December 2009, Pages 194199, Simon Steel, Shane M. Tibby; Paediatric diabetic ketoacidosis, Continuing Education in Anaesthesia Critical Care & Pain, Volume 9, Issue 6, 1 December 2009, Pages 194199, Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with diabetes. Cerebral oedema i ...