糖尿病酮症酸中毒并发急性脑肺同时水肿
Simultaneous acute cerebral and pulmonary edema complicating diabetic ketoacidosis.
作者信息
Young M C
机构信息
Section of Pediatric Endocrinology, Tulane University Medical Center, New Orleans, Louisiana.
出版信息
Diabetes Care. 1995 Sep;18(9):1288-90. doi: 10.2337/diacare.18.9.1288.
OBJECTIVE
To report on a child with diabetic ketoacidosis (DKA) who developed simultaneous acute cerebral edema (CE) and pulmonary edema (PE), required extracorporeal membrane oxygenation (ECMO), and yet survived without significant neurological or pulmonary handicap.
CASE SUMMARY
A 3-year-old girl with DKA as the first manifestation of insulin-dependent diabetes mellitus (IDDM) sustained coincident acute CE and PE 9 h into therapy. The former responded to mannitol, but the latter matured into adult respiratory distress syndrome (ARDS) resistant to conventional management and requiring ECMO.
CONCLUSIONS
CE, PE, and ARDS can complicate DKA. Survival without sequelae is possible with aggressive treatment.
目的
报告一名患有糖尿病酮症酸中毒（DKA）的儿童，该患儿同时发生急性脑水肿（CE）和肺水肿（PE），需要体外膜肺氧合（ECMO）治疗，但最终存活且无明显神经或肺部功能障碍。
病例摘要
一名3岁女孩，胰岛素依赖型糖尿病（IDDM）的首发表现为DKA，在治疗9小时时同时发生急性CE和PE。前者对甘露醇治疗有反应，但后者发展为对传统治疗耐药的成人呼吸窘迫综合征（ARDS），需要ECMO治疗。
结论
CE、PE和ARDS可使DKA复杂化。积极治疗有可能实现无后遗症存活。
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