Abstract
Cerebral edema (CE) and non cardiogenic pulmonary edema (acute respiratory distress syndrome, ARDS) are life-threatening complications of diabetic ketoacidosis (DKA). In contrast to CE complicating DKA, which is primarily reported in pediatric patients, ARDS is rarely described in this age group. Here, the authors present a child with DKA who developed both cerebral edema and ARDS during the course of her management. It is feasible that severe acidosis, hypotension, azotemia, hypoalbuminemia and the superimposed aggressive intravenous fluid administration were important risk factors for the development of cerebral edema and ARDS in the index patient. The report highlights the importance of early diagnosis and aggressive therapy in the management of ARDS, and summarizes the published literature on this rarely reported complication of pediatric DKA.
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GJ, PKD, VB and PKS cared for the patient and commented on the manuscript. EB conceptualised the manuscript, reviewed the literature and contributed to the writing. SS reviewed the literature and wrote the manuscript. VB will act as guarantor for the paper.
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Fig. 1
Radiograph of the chest showing bilateral infiltrates suggestive of ARDS (DOCX 137 kb)
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Sudhanshu, S., Jevalikar, G., Das, P.K. et al. Acute Respiratory Distress Syndrome: A Rare Complication in Pediatric Diabetic Ketoacidosis. Indian J Pediatr 83, 463–465 (2016). https://doi.org/10.1007/s12098-015-1961-6
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DOI: https://doi.org/10.1007/s12098-015-1961-6