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What Causes Cerebral Edema In Dka?

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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.

Suspected Cerebral Edema In Diabetic Ketoacidosis: Is There Still A Role For Head Ct In Treatment Decisions?*

Objectives:Neurologic deterioration associated with cerebral edema in diabetic ketoacidosis is typically sudden in onset, progresses rapidly, and requires emergent treatment. The utility of brain imaging by head CT in decisions to treat for cerebral edema has not been previously studied. The objective of this study was to describe the characteristics of pediatric patients with diabetic ketoacidosis who develop altered mental status and evaluate the role of head CT in this cohort. Design:Retrospective analysis of clinical, biochemical, and radiologic data. Setting:Tertiary care childrens hospital (20042010). Patients:Six hundred eighty-six admissions of patients (< 26 yr) with diabetic ketoacidosis. Measurements and Main Results:Altered mental status was documented during 96 of 686 diabetic ketoacidosis admissions (14%). Compared with alert patients, those with altered mental status were younger (median, 12.0 vs 13.1 yr; p = 0.007) and more acidotic (pH, 7.04 vs 7.19; p < 0.001), with higher serum osmolality (328 vs 315 mOsm/kg; p < 0.001) and longer hospital length of stay (4.5 vs 3 d; p = 0.002). Head CT was performed during 60 of 96 diabetic ketoacidosis admissions with altered Continue reading >>

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  1. Boatswain2PA

    Patient today - 21 yo type 1 diabetic train-wreck (GCS of 4). Na was 124 and I'm trying to figure out why.
    Here's what I remember.
    BP 50/38, P180, R30+
    BS 1390 (after 20 units Insulin)
    K 9.2
    ABGs were horrible, only thing I remember was pH of 6.72
    Urine was clean, but sweet (1000 glucose) .
    Don't remember specifics of other lab values, but they all made sense and could be chalked up to sepsis/DKA.
    I just can't figure out why the Na was 124. I read that Sodium drops by 1 per 62 glucose up to 400, and 1:24 for glucose over 400, but I don't understand why. Pt was incredibly dry so beans would use sodium reuptake to conserve water. Plus through hemoconcentration I would expect a higher sodium concentration.
    So I can't understand why the sodium was at 124. Can anyone help out?

  2. Paseo Del Norte

    Boatswain2PA said: ↑
    Patient today - 21 yo type 1 diabetic train-wreck (GCS of 4). Na was 124 and I'm trying to figure out why.
    Here's what I remember.
    BP 50/38, P180, R30+
    BS 1390 (after 20 units Insulin)
    K 9.2
    ABGs were horrible, only thing I remember was pH of 6.72
    Urine was clean, but sweet (1000 glucose) .
    Don't remember specifics of other lab values, but they all made sense and could be chalked up to sepsis/DKA.
    I just can't figure out why the Na was 124. I read that Sodium drops by 1 per 62 glucose up to 400, and 1:24 for glucose over 400, but I don't understand why. Pt was incredibly dry so beans would use sodium reuptake to conserve water. Plus through hemoconcentration I would expect a higher sodium concentration.
    So I can't understand why the sodium was at 124. Can anyone help out?
    Click to expand... Glucose is osmotically active and causes an intracellular to extracellular shift of water. This acts to effectively "dilute" the Sodium. However, you should run your Sodium through a correction formula in any event. If the corrected Sodium is low, you need to consider other issues such as elevated lipids.

  3. chimichanga

    Wow...I used to love ER, for that very type of pt.
    Now all I can ask is, why the he!! didn't someone bring him in a couple days earlier??
    That kind of pt is EXACTLY the reason why I left the damn ER for good.
    That poor guy was just festering (dying) at home
    FUBAR

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Ncbi cerebral correlates of hyponatremia. Cerebral correlates of hyponatremia. Hyponatremia symptoms, signs, causes & treatment medicinenet. Low sodium level medlineplus medical encyclopedia. Hyponatremia in a young krane dka and cerebral edema pedsccm. Management of hyponatremia american family physician. Manifestations of hyponatremia and hypernatremia in adultscerebral swelling severe caused by water. L of isotonic saline while the syndrome cerebral edema complicating dka was either not seen, ignored, or accounting for 31. The neurologic complications associated with hyponatremia are attributable to cerebral edema and increased intracranial pressure, caused by the osmotically driven movement of water from extracellular compartment into brain cells 28 oct 2014 when occurs, resulting decrease in plasma osmolality (with exception rare cases non hypoosmotic hyponatremia) causes response osmotic gradient, thus causing [7,8] (figure 1b) this setting, fall serum creates an osmolal gradient that favors cells, leading is excess accumulation fluid intracellular or spaces certain changes morphology becomes soft smooth can be diluted several mechanisms, including excessive intake (or hypona

Cerebral Edema - Wikipedia

Cerebral edema is excess accumulation of fluid in the intracellular or extracellular spaces of the brain . Certain changes in morphology are associated with cerebral edema: the brain becomes soft and smooth and overfills the cranial vault , gyri (ridges) become flattened, sulci (grooves) become narrowed, and ventricular cavities become compressed. Cerebral edema can result from brain trauma or from nontraumatic causes such as ischemic stroke , cancer , or brain inflammation due to meningitis or encephalitis . [1] Vasogenic edema caused by amyloid-modifying treatments, such as monoclonal antibodies , is known as ARIA-E (amyloid-related imaging abnormalities edema). The bloodbrain barrier (BBB) or the blood cerebrospinal fluid (CSF) barrier may break down, allowing fluid to accumulate in the brain's extracellular space. Altered metabolism may cause brain cells to retain water , and dilution of the blood plasma may cause excess water to move into brain cells. Vasogenic edema occurs due to a breakdown of the tight endothelial junctions that make up the bloodbrain barrier. This allows intravascular proteins and fluid to penetrate into the parenchymal extracellular space. Once plasma co Continue reading >>

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  1. ianrobo

    Surprised no sub forum for this but after watching food unwrapped and reading up on it I am now going on the 16-8 diet. This is of course Keto but only eating within a 8 hour window. For me it is going to mean mainly no breakfasts. Occasionally I may break this because riding into work makes me hungry but have breakfast as late as possible ! It is of course intermittent fasting and something I do anyway 3/4 times a week.

  2. ketomarriage4life

    Posting in here too. Need to get back into 16 - 8 after having December off!

  3. betsy.rome

    I am planning on trying this later this month. RIght now, getting back on the horse is my plan, IF later when the hunger goes buh-bye. Let us know how it's going, thanks.

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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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Popular Questions

  1. Amy Chai

    Ketosis rash means that your body does not like being in ketosis and it means that you are restricting your carbohydrates too much. That is not healthy.

  2. Jay William Litwyn

    I don’t think ketosis is a state you want to be in continually. It comes naturally with fasting, which is a religious ritual that Muslims observe in a season that varies with the moon. Meanwhile, some Christian sects observe fasting during lent and advent. It is

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