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Evaluation of clinical versus radiological measures in the early diagnosis of cerebral edema in diabetic ketoacidosis
المؤلفون المشاركون
Adli A. A.
G., Abu al-Muti M.
Abu Shadi, Manal Muhammad
المصدر
Egyptian Journal of Applied Endocrinology
العدد
المجلد 26، العدد 1-2 (31 يوليو/تموز 2008)، ص ص. 163-178، 16ص.
الناشر
الجمعية المصرية للغدد الصماء التطبيقية
تاريخ النشر
2008-07-31
دولة النشر
مصر
عدد الصفحات
16
التخصصات الرئيسية
الموضوعات
الملخص EN
Cerebral edema (CE) complicating diabetic ketoacidosis (DKA) remains the major cause of morbidity and mortality in children and adolescents with type 1diabetes, but its etiology remains unknown.
The clinician’s decision to intervene is particularly important, since early treatment is critical in preventing neurological demise. Aim of the study: To evaluate the efficacy of brain CT scan versus clinical examination in the early detection of cerebral edema in patients with DKA.
We also aimed to determine the impact of baseline biochemical factors on risk of development of cerebral edema in patients with DKA. Subjects and methods: 30 type 1 diabetic patients with DKA, admitted to the emergency room in the Children& Internal medicine Hospitals of Ain Shams University, were included in this study.
Bedside neurological assessment of cerebral edema and Glasgow coma scale were done.
Brain computed tomograms were done for all patients, and their reports were reviewed.
Results: Nine patients (30%) with DKA developed clinical cerebral edema.
Of those, only 3 (10%) showed radiological evidence of cerebral edema.
Patients who developed cerebral edema had one or more risk factors: young age, rapid decline of random blood sugar, hyponatremia, hyperkalemia, HCO3 < 18, pH < 7 or presented with severe dehydration.
Infection was the most common precipitating factor for DKA attacks.
Complications noted during treatment were hypokalemia (n = 14; 46.6%), hyponatremia (n = 16; 53.3%), hypoglycemia (n = 10; 30.3%), and cerebral edema (n = 9; 30%). Conclusion: CE may occur in the absence of acute changes on brain computed tomograms.
CE in the context of DKA is a clinical, not a radiological diagnosis.
The degree of edema formation during DKA in children was correlated with the degree of dehydration, baseline acidosis, low plasma sodium and higher potassium levels.
These biochemical factors were important predictors of risk of development of cerebral edema.
Early detection of CE at the bedside using an evidence-based protocol permits intervention in time to prevent permanent brain damage.
نمط استشهاد جمعية علماء النفس الأمريكية (APA)
Adli A. A.& G., Abu al-Muti M.& Abu Shadi, Manal Muhammad. 2008. Evaluation of clinical versus radiological measures in the early diagnosis of cerebral edema in diabetic ketoacidosis. Egyptian Journal of Applied Endocrinology،Vol. 26, no. 1-2, pp.163-178.
https://search.emarefa.net/detail/BIM-248778
نمط استشهاد الجمعية الأمريكية للغات الحديثة (MLA)
Adli A. A.…[et al.]. Evaluation of clinical versus radiological measures in the early diagnosis of cerebral edema in diabetic ketoacidosis. Egyptian Journal of Applied Endocrinology Vol. 26, no. 1-2 (Jul. 2008), pp.163-178.
https://search.emarefa.net/detail/BIM-248778
نمط استشهاد الجمعية الطبية الأمريكية (AMA)
Adli A. A.& G., Abu al-Muti M.& Abu Shadi, Manal Muhammad. Evaluation of clinical versus radiological measures in the early diagnosis of cerebral edema in diabetic ketoacidosis. Egyptian Journal of Applied Endocrinology. 2008. Vol. 26, no. 1-2, pp.163-178.
https://search.emarefa.net/detail/BIM-248778
نوع البيانات
مقالات
لغة النص
الإنجليزية
الملاحظات
Includes bibliographical references : p. 171-172.
رقم السجل
BIM-248778
قاعدة معامل التأثير والاستشهادات المرجعية العربي "ارسيف Arcif"
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