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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.

Diabetic Ketoacidosis Related Cerebral Edema

Diabetic Ketoacidosis Related Cerebral Edema Diabetic Ketoacidosis Related Cerebral Edema Aka: Diabetic Ketoacidosis Related Cerebral Edema, DKA related Cerebral Edema Incidence : 0.5 to 1% of Diabetic Ketoacidosis patients Younger children (<5 years old) with new onset of diabetes and longer duration of symptoms 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 V. 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 Persistent vegatative state in up to one third of surviving children Aurora and Menchine in Herbert (2014) EM:Rap 14(1): 10-11 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Diabetic Ketoacidosis Related Cerebral Edema." Click on the image (or right click) to open the source website in a new browser window. Search Bing for all related images Related Studies (from Trip Database) Open in New Window Continue reading >>

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  1. sonias

    3 This is my topic for this week in nursing school, respiratory & metabolic acidosis/ alkalosis. I am having trouble breaking it down. Can someone please help me understand this please? Any and all help is greatly appreciated.

  2. Esme12

    Normal values:
    PH = 7.35 - 7.45
    C02 = 35 - 45
    HC03 = 21-26
    Respiratory acidosis = low ph and high C02
    hypoventilation (eg: COPD, narcs or sedatives, atelectasis)
    *Compensated by metabolic alkalosis (increased HC03)
    For example:
    ph 7.20 C02 60 HC03 24 (uncompensated respiratory acidosis)
    ph 7.33 C02 55 HC03 29 (partially compensated respiratory acidosis)
    ph 7.37 C02 60 HC03 37 (compensated respiratory acidosis)
    Respiratory alkalosis : high ph and low C02
    hyperventilation (eg: anxiety, PE, pain, sepsis, brain injury)
    *Compensated by metabolic acidosis (decreased HC03)
    examples:
    ph 7.51 C02 26 HC03 25 (uncompensated respiratory alkalosis)
    ph 7.47 C02 32 HC03 20 (partially compensated respiratory alkalosis)
    ph 7.43 C02 30 HC03 19 (compensated respiratory alkalosis)
    Metabolic acidosis : low ph and low HC03
    diabetic ketoacidosis, starvation, severe diarrhea
    *Compensated by respiratory alkalosis (decreased C02)
    examples:
    ph 7.23 C02 36 HC03 14 (uncompensated metabolic acidosis)
    ph 7.31 C02 30 HC03 17 (partially compensated metabolic acidosis)
    ph 7.38 C02 26 HC03 20 (compensated metabolic acidosis)
    Metabloic alkalosis = high ph and high HC03
    severe vomiting, potassium deficit, diuretics
    *Compensated by respiratory acidosis (increased C02)
    example:
    ph 7.54 C02 44 HC03 29 (uncompensated metabolic alkalosis)
    ph 7.50 C02 49 HC03 32 (partially compensated metabolic alkalosis)
    ph 7.44 C02 52 HC02 35 (compensated metabolic alkalosis)
    *Remember that compensation corrects the ph.
    Now a simple way to remember this......
    CO2 = acid, makes things acidic
    HCO3 = base, makes things alkalotic
    Remember ROME
    R-Respiratory
    O-Opposite
    M-Metabolic
    E-Equal
    Ok always look at the pH first...
    pH<7.35 = acidosis
    pH>7.45 = alkalosis
    Then, if the CO2 is high or low, then it is respiratory...If the HCO3 is high or low then it is metabolic. How you remember that is that the respiratory system is involved with CO2 (blowing air off or slowing RR), and the kidneys (metabolic) are involved with HCO3 (excreting or not excreting).
    Here is how you think thru it: pH = 7.25 CO2 = 40 HCO3 = 17
    Ok, first, the pH is low so think acidosis. CO2 is WNL. HCO3 is low. Draw arrows if it helps. The abnormal values are both low (think Equal). Metabolic imbalances are equal. So, this must be metabolic acidosis!
    Now, for compensation...If you have a metabolic imbalance, the respiratory system is going to try to compensate. Respiratory = CO2. If the CO2 is normal in the ABG, then there is no compensation going on. Compensation in acidosis will decrease the CO2 because you want to get rid of the acid (CO2). In alkalosis, it will increase because you want to add more acid (CO2)
    If you have a respiratory imbalance, the kidneys will try to compensate. Kidneys = HCO3. If the HCO3 is normal in the ABG, then there is no compensation going on. Compensation in acidosis will increase HCO3 because you want to hold on to the base to make it more alkalotic. In alkalosis, it will decrease because you want to excrete the base to make it more acidic.

  3. Esme12

    Check out this tutorial
    Interactive Online ABG's acid base

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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

Cerebral Edema In Dka

Please donate! Funds go solely to hosting and development costs that allow medical practitioners around the globe to freely access WikEM. Almost all affected patients are <20yr [2] Associated with initial bicarb level; not rate of glucose drop Overaggressive fluid resuscitation is NOT a risk factor Begins 6-12hr after onset of therapy or may begin before initiation of treatment or up to 48h afterward Many appear to be improving from their DKA before deteriorating from cerebral edema Mannitol 0.5-1gm/kg IV bolus over 20 minutes Give a repeat does if there is an inadequate response If 2 doses of mannitol are ineffective, consider 3% saline 10mL/kg over 30min Fluid restriction - decrease the IVF infusion rate by 30% Treat noncardiogenic pulmonary edema , if present Cooke & Plotnick. Management of diabetic ketoacidosis in children and adolescents. Pediatr Rev. 2008 Dec;29(12):431-5 Glaser NS, Wootton-Gorges SL, Buonocore MH, Marcin JP, Rewers A, Strain J, et al. Frequency of sub-clinical cerebral edema in children with diabetic ketoacidosis. Pediatr Diabetes. Apr 2006;7(2):75-80. Cooke & Plotnick. Management of diabetic ketoacidosis in children and adolescents. Pediatr Rev. 2008 Dec;2 Continue reading >>

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Popular Questions

  1. Likhita Iyer

    how can differentiate between aldehyde and ketone

  2. Shukla Paladhi

    Dear user,
    Aldehydes and ketones can be differentiated as under.
    Test
    Aldehydes
    Ketones
    Tollen’s reagent test
    +ve
    Aldehydes reduce Tollens’ reagent to form shiny silver mirror.
    -ve
    Ketones do not reduce Tollens’ reagent and hence, there is no formation of shiny silver mirror.
    Fehling’s solution test
    +ve
    Aldehydes reduce Fehling’s solution to form red precipitates of cuprous oxide.
    -ve
    Ketones do not reduce Fehling’s solution and hence, there is no of red precipitate formation.
    Schiff’s reagent test
    +ve
    Aldehydes restore the pink colour of Schiff’s reagent.
    -ve
    Ketones do not restore the pink colour of Schiff’s reagent.
    Reduction with LiAlH4
    Aldehydes get reduced to primary alcohols in presence of LiAlH4.
    Ketones get reduced to secondary alcohols in presence of LiAlH4.
    Hope, this answers your question.

    Cheers!!

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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 b

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. KimberlyFL30

    I remember reading that once your body goes into ketosis, your body odor can change. I forget the entire reasoning behind why it happens. I have been low-carbing for a few months now, not as strict as Atkins, but slowly losing weight and watching my carb intake. And I think I do notice a change in my body odor, am I crazy?? I was wondering if anyone else has heard of this or noticed this themselves....and if so, any suggestions on what to do about it?? It's not like body odor from sweating, and not a strong or bad smell. I've even asked my mom (thank god for mom's...who else could I ask about this!!) and she says she doesn't a thing....so maybe it's all in my head from having read something about it.
    Anyways, any information/experiences anyone may have would be greatly appreciated. Instead of saying it's "all in my head" maybe it's "all in my nose!"....who knows LOL
    Thanks,
    Kim

  2. LeannKanzia

    I know someone who did Atkins for a year (the no carb phase, he never worked them back into his diet...bad bad bad) and he alwasy smelled "funny". Not bad or anything, just different, almost sweet which I always found odd since he had no sugars in his body. We all have our own scents, I think low carbing might just bring them out more for some reason.
    I don't think it's anything to worry about, noone else is probably noticing it besides the people you are really close to.

  3. Ajani

    If it's a concern, you can do the following.
    Make a tea of fresh sage leaves. Let it steep for about an hour, and strain. Let it cool and keep it in the fridge. Each day, dip a clean cloth in and wipe it all over your body. Sage is a natural deoderizer. You can also sprinkle powdered sage in your shoes, to inhibit foot odour.

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