Brain injury in children with diabetic ketoacidosis: Review of the literature and a proposed pathophysiologic pathway for the development of cerebral edema.
brain injury
cerebral edema
diabetes mellitus
diabetic ketoacidosis
pediatrics
Journal
Pediatric diabetes
ISSN: 1399-5448
Titre abrégé: Pediatr Diabetes
Pays: Denmark
ID NLM: 100939345
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
received:
24
08
2020
revised:
06
10
2020
accepted:
29
10
2020
pubmed:
17
11
2020
medline:
11
1
2022
entrez:
16
11
2020
Statut:
ppublish
Résumé
Cerebral edema (CE) is a potentially devastating complication of diabetic ketoacidosis (DKA) that almost exclusively occurs in children. Since its first description in 1936, numerous risk factors have been identified; however, there continues to be uncertainty concerning the mechanisms that lead to its development. Currently, the most widely accepted hypothesis posits that CE occurs as a result of ischemia-reperfusion injury, with inflammation and impaired cerebrovascular autoregulation contributing to its pathogenesis. The role of specific aspects of DKA treatment in the development of CE continues to be controversial. This review critically examines the literature on the pathophysiology of CE and attempts to categorize the findings by types of brain injury that contribute to its development: cytotoxic, vasogenic, and osmotic. Utilizing this scheme, we propose a multifactorial pathway for the development of CE in patients with DKA.
Identifiants
pubmed: 33197066
doi: 10.1111/pedi.13152
pmc: PMC10127934
mid: NIHMS1648950
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
148-160Subventions
Organisme : NIDDK NIH HHS
ID : T32 DK007699
Pays : United States
Organisme : NIDDK NIH HHS
ID : 5T32DK007699-39
Pays : United States
Informations de copyright
© 2020 John Wiley & Sons A/S . Published by John Wiley & Sons Ltd.
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