Natarajan Sameera, Kulkarni Radhika, Tangri Apoorva
Advocate Illinois Masonic Medical Center, 836 W Wellington Ave., Chicago, IL 60657, USA.
University of Connecticut: UConn Health, 263 Farmington Ave., Farmington, CT 06030, USA.
Case Rep Crit Care. 2020 Apr 30;2020:5917459. doi: 10.1155/2020/5917459. eCollection 2020.
Cerebral edema is a devastating complication of DKA which is extremely rare in adults but is the leading cause of diabetes-related death in the pediatric population. Newly diagnosed diabetes, younger age, first episode of DKA, severity of DKA at presentation, and administration of bicarbonate are predictive of cerebral edema in DKA. We present a case of a young adult with DKA as the presenting symptom of diabetes, whose clinical course was complicated by renal failure, refractory shock, and cerebral edema. This case addresses the controversy surrounding bicarbonate therapy in DKA and its possible role in the development of a rare fatal complication of DKA.
脑水肿是糖尿病酮症酸中毒（DKA）的一种严重并发症，在成人中极为罕见，但却是儿童糖尿病相关死亡的主要原因。新诊断的糖尿病、年龄较小、DKA首发、就诊时DKA的严重程度以及碳酸氢盐的使用是DKA发生脑水肿的预测因素。我们报告一例以DKA为糖尿病首发症状的年轻成人病例，其临床病程并发了肾衰竭、难治性休克和脑水肿。该病例探讨了围绕DKA中碳酸氢盐治疗的争议及其在DKA一种罕见致命并发症发生中的可能作用。
