How Can Diabetic Ketoacidosis Cause Cerebral Edema In Infants?
Diabetic Ketoacidosis (DKA) in and of itself does not cause cranial edema. What happens with DKA is the excess glucose in the blood changes the osmolarity of the blood, and causes fluid shift from intracelluar to extracellular. This causes the cells to shrink somewhat. Upon finding the patient in the DKA state, the teatment is insulin and IV fluids. Insulin and the hydration IV fluids reverse the DKA state, and also the osmolarity of the extracellular fluid, causing a fluid shift back into the cell. With the osmolarity reversed, the cells begin swelling—sometimes sometimes larger than before: this is what causes the edema in the cerebrum. This is particularly dangerous because the brain cells have nowhere to go, being encased within the skull. Even though infants have fontanelles and the skull has not fused solid, the extra fluid causes compression within the brain, which in turn can adversely affect the brain function. Continue reading >>