© 2004 BMJ Publishing Group Ltd, British Association for Accident & Emergency Medicine, & Faculty of Accident & Emergency Medicine
REVIEW
Cerebral oedema in childhood diabetic ketoacidosis: Is treatment a factor?
Correspondence to:
Correspondence to:
Dr T B Brown
UCLA Emergency Medicine Center, 23630 Latana Court, Valencia, CA 91355, USA; tbransonbrown{at}attbi.com
Cerebral oedema (CO) is the most dreaded complication of diabetic ketoacidosis (DKA) in children. Despite advances in many areas of the management of DKA, the mortality from CO has remained constant for decades. This rare disorder, complicating about 1% of cases of DKA in children, is lethal in 20% to 50% of victims. Since it was first described in 1936, much effort has gone into the search for a cause for this condition, but CO in childhood DKA remains a mysterious illness. Researchers have suggested that the treatment for DKA may be causally related to the development of CO. Others have disputed this claim, and both camps cite evidence to support their point of view. This article reviews the literature pertinent to the question: Is the treatment of DKA in children responsible for the development of CO?
Keywords: cerebral oedema; diabetes; ketoacidosis
Abbreviations: CO, cerebral oedema; DKA, diabetic ketacidosis
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