Dka Cerebral Edema Risk Factors

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In this video, Dr. Michael Agus discusses the risk factors, signs, symptoms, and treatment of cerebral edema in diabetic ketoacidosis. Please visit: www.openpediatrics.org OPENPediatrics is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user. For further information on how to enroll, please email: [email protected] Please note: OPENPediatrics does not support nor control any related videos in the sidebar, these are placed by Youtube. We apologize for any inconvenience this may cause.

Original Article Population-based Study Of Incidence And Risk Factors For Cerebral Edema In Pediatric Diabetic Ketoacidosis

Objectives To determine incidence, outcomes, and risk factors for pediatric cerebral edema with diabetic ketoacidosis (CEDKA) in Canada. This was a case-control study nested within a population-based active surveillance study of CEDKA in Canada from July 1999 to June 2001. Cases are patients with DKA <16 years of age with cerebral edema. Two unmatched control subjects per case are patients with DKA without cerebral edema. Thirteen cases of CEDKA were identified over the surveillance period for an incidence rate of 0.51%; 23% died and 15% survived with neurologic sequelae. CEDKA was present at initial presentation of DKA in 19% of cases. CEDKA was associated with lower initial bicarbonate (P = .001), higher initial urea (P = .001), and higher glucose at presentation (P = .014). Although there was a trend to association with higher fluid rates and treatment with bicarbonate, these were not independent predictors. Conclusions CEDKA remains a significant problem with a high mortality rate. No association was found between the occurrence of CEDKA and treatment factors. The presence of cerebral edema before treatment of DKA and the association with severity of illness suggest that preven Continue reading >>

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  1. xueye

    Hi, friends!
    My girlfriend and I have been doing keto for awhile (me about 18 months, her about 6 months).
    For the last month or so, my girlfriend has been losing hair. We've read up and figured out that it's not entirely uncommon (especially because in her first 3 months she lost about 20lb, and has stalled for reasons we can't figure it out). When it started she began to take calcium and multivitamins to try and make it help, but it hasn't appeared to do anything yet.
    Her hair is one of her favorite parts about herself, as she's always had beautiful long hair; naturally, the hair loss is taking a toll on her.
    Unfortunately, I have short hair and I have never noticed if anything has happened to me like this, so can't guide her.
    We've read around and it seems like it could be any number of things. Our current plan is to bump up green vegetables (like spinach, kale, and brocolli) and to add more protein (we're wondering if she hit fat too hard and protein too little). We're also considering swapping the vitamins to add Biotin into the mix because it seems to have fantastic hair and nail reviews.
    Even though we've got a plan, we were wondering if anyone that's gone through this that can give us encouragement or advice. This is the first time keto has given us something to be concerned about. We're not even sure how long we should expect any changes to take, and I think the unknown part of this all is what scares us the most.
    Any advice? Tips? Anecdotes? We're all ears!
    Thanks so much, you guys are always the best!
    (And if you're reading this, I love you babe!)

  2. sollevatore

    Is her hair noticeably thinner?
    If not, the hair loss is a normal thing that most women experience. I personally have very long, thick hair and it goes through cycles where it sheds CONSTANTLY. I will pull out fistfuls of it in the shower and yet it doesn't actually affect the thickness of my hair because it's a normal thing that has to happen.
    If her hair IS getting thinner or you're noticing bald spots, she needs to see a doctor. This subreddit isn't a replacement for actual medical advice. It could be some sort of deficiency but unfortunately no one here will be able to tell you/her for sure.

  3. misstrev

    Hi! I am the girlfriend! I wasn't sure if my hair was thinning or not so I asked my co-worker and she said that it looks like I still have a lot of hair, so this morning when I was straightening my hair I realized that my head looks full because half of my hair is between 1-3 inches long. SO, I am assuming it is falling off and just growing back, which is a good sign! I guess I am just gonna have to cut it until it all evens out.
    Thanks for everything! :)

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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.....

Paediatric Diabetic Ketoacidosis

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 is the most common cause of death and a high index of suspicion is always required. Cerebral oedema may be exacerbated by factors related to both DKA presentation and therapy. I.V. fluid boluses should be given cautiously. Always use low-dose insulin regimes and avoid insulin boluses. Misinterpretation of acidbase abnormalities is avoided when changes in pH and base deficit are viewed in conjunction with the anion gap (the latter being a better representation of resolution of ketoacidosis). Diabetic ketoacidosis (DKA) can occur with both types 1 and 2 diabetes mellitus, 1 and is the leading cause of morbidity and mortality in children with diabetes. 2 Unlike the adult population, paediatric mortality is mainly due to the development of cereb Continue reading >>

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  1. __ish

    So, long story short, I remember reading somewhere that a great way to help speed your body's entry into ketosis is to do a 24 hour fast and some low intensity exercise. Trouble is, I can't seem to find where it was that I read that! Did I dream it up? Is this a thing?

  2. __loridcon

    i believe what you read is this:

  3. __ish

    Yes! Thank you!
    I stopped eating at 3PM and did the wrong kind of exercise tonight instead of tomorrow morning, but that can be remedied.
    Has anyone had success with this method? This will be my first real go at keto.

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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 [12] 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,

Cerebral Edema: A Complication Of Dka

DKA, or diabetic ketoacidosis, is a severe life-threatening medical complication that must be treated by doctors in a hospital. DKA is a condition in which blood glucose levels have risen dangerously high due to lack of insulin and insulin resistance. Fat begins to break down in response to energy requirements leading to high ketone levels in the blood causing your blood to become too acidic. DKA sometimes leads to cerebral edema, which is brain swelling, and if left untreated, cerebral edema can cause brain damage or lead to death. Cerebral Edema: Its relationship to DKA In order to understand cerebral edema, you must understand diabetic ketoacidosis (DKA). DKA is a situation in which blood sugar levels rise to dangerous levels in response to a lack of insulin and insulin resistance. The liver keeps producing glucose, which collects in the blood. Normally, insulin will move that glucose out of the blood and into the cells that need it, but when there is insufficient insulin or significant insulin resistance, the glucose builds up to dangerous levels (severe hyperglycemia). Because the cells that need the glucose are not getting it (remember the glucose is stuck in the blood), they Continue reading >>

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  1. carissanbo

    I'm just wondering if there are ways to tell if you're in Ketosis without using the strips. We live in the Outback in Australia in a small town and I'm not sure I would be able to find them here. And to be honest, I really don't feel like checking. I feel that I finally found a WOE that works for me and I'm feeling great and don't want to focus too much on that aspect. So I'm wondering if there are signs to tell me.
    I'm finishing up my 3rd day of induction and to be honest, it's been pretty easy for me. I haven't really had any bad side effects and after supper I have no urges or cravings to eat anything (and no urges for carbs during the day). I have ALWAYS had a snack before bed my whole life, but I've really had no interest.
    I just want to make sure I'm doing this right. If you go to my journal you can check out my menu for today if you'd like to see what I'm eating. And I have lost a few pounds.

  2. Sinbad

    You should update your profile with your weight loss so we can share your happiness
    As for ketosis, I can tell without strips because I sometimes get an odd tinny taste in my mouth, I don't feel hungry or sluggish or headachey at all, and most convincing of all (for me) is that my pee smells almost of acetone... Sometimes it looks almost greenish too but that could be because of the supplements I'm taking (or all the green veggies I'm eating, which I never used to! )
    Of course, the best sign that you're in ketosis/lipolysis is that you're losing weight!
    Good luck with the plan!

  3. btdude

    Agreed. Metal mouth prevails. You are in the bathroom every (at least) 35.4 minutes.

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