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What Causes Cerebral Edema In Dka?

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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.....

Aetiology Of Cerebral Oedema In Diabetic Ketoacidosis | Emergency Medicine Journal

Aetiology of cerebral oedema in diabetic ketoacidosis Aetiology of cerebral oedema in diabetic ketoacidosis Department of Emergency Medicine, Royal Brisbane Hospital, Herston, Brisbane, Queensland 4029, Australia; af.brownuq.edu.au The excellent evidence based review of the emergency management of diabetic ketoacidosis (DKA) in adults by Hardern and Quinn perpetuates the premise that unnecessarily large volumes of intravenous fluids should be avoided because of the high case fatality rate of cerebral oedema. 1 This presupposes that the rate of fluid delivery is causally related to the development of cerebral oedema, which has not been proved. The large 15 year paediatric study in the USA that analysed 6977 hospitalisations for DKA found among the 61 cases of cerebral oedema (0.9%) that after multiple logistic-regression analysis with random and matched controls, the only variables statistically associated with cerebral oedema were higher initial serum urea nitrogen concentrations and lower partial pressures of carbon dioxide at presentation. 2 In addition, smaller increases in serum sodium concentration during treatment and the use of bicarbonate were also implicated. Importantly, Continue reading >>

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Popular Questions

  1. x5452me

    i was just woundring how long it takes your body to go into starvation mode because i plan on going on baby food diet tomoro then when my belly shrinks and is used to only lil bit in it fast but im not sure for how long cause i dont want to gain back what ever weight i lose
    any info would be good
    thanks hope your all well

  2. XxCrystal_butterflyxx

    It varies for each person, depending on their metabolism. For me I can only fast 6 days, then my metabolism completely shuts down. So my cycle right now is fast Monday-Friday then eat Saturday- Sunday and repeat. This keeps my metabolism going. (: other wise ill stop losing weight and I hate when that happens!

  3. x5452me

    thanks and how did you figure out the balance?

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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.

Risk Factors For Cerebral Edema In Children With Diabetic Ketoacidosis

Cerebral edema is an uncommon but devastating complication of diabetic ketoacidosis in children. Risk factors for this complication have not been clearly defined. In this multicenter study, we identified 61 children who had been hospitalized for diabetic ketoacidosis within a 15-year period and in whom cerebral edema had developed. Two additional groups of children with diabetic ketoacidosis but without cerebral edema were also identified: 181 randomly selected children and 174 children matched to those in the cerebral-edema group with respect to age at presentation, onset of diabetes (established vs. newly diagnosed disease), initial serum glucose concentration, and initial venous pH. Using logistic regression, we compared the three groups with respect to demographic characteristics and biochemical variables at presentation and compared the matched groups with respect to therapeutic interventions and changes in biochemical values during treatment. A comparison of the children in the cerebral-edema group with those in the random control group showed that cerebral edema was significantly associated with lower initial partial pressures of arterial carbon dioxide (relative risk of cer Continue reading >>

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  1. Melissa_Carver

    Hi all! I’m new here and to ketosis, 10 days in and feeling great!
    So I was listening to the 2 Keto Dudes episode on sweeteners and they were talking about how one sweetener or the other would “knock them out of ketosis.” How do you know when you’ve been knocked out of ketosis? Is it a blood sugar thing? Or are you using a ketone tester (blood/breath/urine strip) to verify?
    (Note: I’m T1D, 25 years now, diagnosed as a kid. I just started wearing my CGM again today to try to level off the blood sugars and adjust my basal rate in my insulin pump as needed. If I can tell by blood sugar if I’m knocked out of ketosis that would perfect and so easy for me!)

    Thanks in advance everyone!

  2. Ernest

    Most likely from experimentation to test tolerance.
    I did a protein tolerance experiment and I’d test my ketone readings, using the Precision Xtra, a few times after eating a large amount of protein .
    I bet one could do the same experiment with sweeteners.

  3. Rian

    There are a few sure ways to know if you are in ketosis. In my opinion the most reliable and easiest way is to acquire a blood ketone test meter. Many people here like the Abbott Precision Xtra. The strips to test ketones are a few bucks each but if you try eBay you can usually get them a little cheaper. You will have to do a fair amount of testing in the beginning to see what foods do what to your ketone levels but after awhile you’ll become familiar with the do’s and don’t and will only need to test or occasion.

    Testing for ketones isn’t a requirement but it is nice to know what’s going on without resorting to guessing.

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How to Present a Patient: Series for Medical Students Texas Tech University Health Sciences Center School of Medicine in Lubbock Ashley, 2 Weeks, Female

Pediatric Diabetic Ketoacidosistreatment & Management

Pediatric Diabetic KetoacidosisTreatment & Management Author: William H Lamb, MD, MBBS, FRCP(Edin), FRCP, FRCPCH; Chief Editor: Timothy E Corden, MD more... In patients with diabetic ketoacidosis, the first principals of resuscitation apply (ie, the ABCs [airway, breathing, circulation]). [ 3 ] Outcomes are best when children are closely monitored and a changing status is promptly addressed. [ 39 , 2 ] Give oxygen, although this has no effect on the respiratory drive of acidosis. Diagnose by clinical history, physical signs, and elevated blood glucose. Fluid, insulin, and electrolyte (potassium and, in select cases, bicarbonate) replacement is essential in the treatment of diabetic ketoacidosis. Early in the treatment of diabetic ketoacidosis, when blood glucose levels are very elevated, the child can continue to experience massive fluid losses and deteriorate. Strict measurement of fluid balance is essential for optimal treatment. Continuous subcutaneous insulin infusion therapy using an insulin pump should be stopped during the treatment of diabetic ketoacidosis. Children with severe acidosis (ie, pH < 7.1) or with altered consciousness should be admitted to a pediatric intensiv Continue reading >>

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  1. xSinead

    Silly question since i've been on cambridge almost 6 weeks now.. but i've been doing SS+ for about 10 days, and the past 4 days i've done SS, ive got the metal taste in my mouth and no longer feeling hungry.. so i think i'm probably in ketosis now?
    I get weighed at 5pm tonight, lord help me pleaaaaaaaase.

  2. Charlie Woo Woo

    xSinead said:
    Silly question since i've been on cambridge almost 6 weeks now.. but i've been doing SS+ for about 10 days, and the past 4 days i've done SS, ive got the metal taste in my mouth and no longer feeling hungry.. so i think i'm probably in ketosis now?
    I get weighed at 5pm tonight, lord help me pleaaaaaaaase. Im not too sure but it sounds like you are in ketosis. Does ss+ knock people out of ketosis or is it a milder ketosis?
    Sorry pretty new to this so am unsure
    Good luck for 5pm x

  3. AnnieAnnie

    You stay in ketosis at ss+ & 810 generally too. Although I find as soon as I eat I lose the taste of metal (but stay in ketosis). Hope this makes sense.

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