Nighat Sultana, Attia Bari, Muhammad Sarwar, Afsheen Batool Raza, Muhammad Zeeshan Khan Khosa, Muhammad Haroon Hamid.
Risk Factors of Cerebral Edema in Diabetic Ketoacidosis admitted in PICU of a Tertiary Care Hospital.
Pak Paed J Jan ;45(4):457-62.

Objective: To determine the risk factors for development of cerebral edema in children with Diabetic Ketoacidosis (DKA). Study Design: An observational study. Place and Duration of Study: Pediatric Critical Care Unit of The Children`s Hospital and the Institute of Child Health, Lahore from February 2015 to December 2018. Material and Methods: An observational study conducted at Pediatric Critical Care Unit of the Children`s Hospital and the Institute of Child Health, Lahore in children up to the age of 16 years with T1DM who presented with DKA from February 2015 to December 2018. Data analysis was done by SPSS. Statistical significance was analyzed and chi square test was applied for categorical variables and p value <0.05 was considered significant. Results: A total of 152 patients with DKA were included having mean age of 7.86 +- 4.06 years. Majority of cases 89 (59%) were of new onset diabetes. The factors associated with increased relative risk of cerebral edema were unconsciousness at presentation (OR: 5.470; 95% CI: 2.822-10.603) (p=<0.001), initial treatment at periphery/local hospital (OR: 2.420; 95% CI: 1.449-4.042) (p=0.001), severe metabolic acidosis (OR: 11.370; 95% CI: 1.624-79.586) (p=<0.001), hypernatremia (p=<0.001) and hypokalemia (p=0.02). Conclusion: Unconsciousness at presentation, initial treatment at periphery/local hospital, severe metabolic acidosis, hypernatremia and hypokalemia were most common risk factors identified for development of cerebral edema.

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