Determination of cerebral edema with serial measurement of optic nerve sheath diameter during treatment in children with diabetic ketoacidosis: a longitudinal study
-
Ozlem Tolu Kendir
,
Hayri Levent Yilmaz
Abstract
Background
Cerebral edema is a fatal complication that can occur in children with diabetic ketoacidosis (DKA). Its clinical signs are generally not explicit, and subclinical cerebral edema can occur. This study is one of the few longitudinal studies conducted to identify cerebral edema in patients with DKA by measuring the optic nerve sheath diameter (ONSD). The aim of this study was to investigate cerebral edema in children with DKA with serial measurement of ONSD, which is an early and reliable indicator of cerebral edema, and to monitor changes in ONSD during therapy.
Methods
The study was conducted by measuring ONSD ultrasonographically at baseline and during the course of therapy in patients with DKA. All participants were diagnosed and received therapy at our unit between May 2016 and June 2017. The study was registered with the Clinical Trials database, with a study number of NCT02937441. Measurements were obtained while the patients were in the supine position with their eyes closed, and axial transbulbar images of both eyes were obtained with a 6–15-MHz linear probe.
Results
The ONSD values of children with DKA changed during the treatment, reaching the highest values at 12–16 h of therapy, and the greatest ONSD was observed in children who had moderate and severe DKA.
Conclusions
During treatment of children with DKA, it is possible to predict cerebral edema by measuring ONSD, and this may contribute to clinical management, especially fluid treatment.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: No funding was received for this article.
Employment or leadership: No employment.
Honorarium: There is no any honorarium.
Competing interests: There are no competing interests.
References
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© 2019 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
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- Future glycemic control of children diagnosed with type 1 diabetes mellitus at toddler and preschool/school age
- Children with type 1 diabetes of early age at onset – immune and metabolic phenotypes
- Determination of cerebral edema with serial measurement of optic nerve sheath diameter during treatment in children with diabetic ketoacidosis: a longitudinal study
- Association between inflammation, oxidative stress, vitamin D, copper and zinc with pre-obesity and obesity in school children from the city of Podgorica, Montenegro
- Phenotypic diversity and correlation with the genotypes of pseudohypoaldosteronism type 1
- Start low, go slowly – mental abnormalities in young prolactinoma patients under cabergoline therapy
- Primary ovarian insufficiency in an adolescent population: clinical phenotype and diagnostic approach
- Novel combined insulin-like 3 variations of a single nucleotide in cryptorchidism
- Evaluation of the abdominopelvic region using MRI in patients with primary amenorrhea
- Benefits of aerobic training in girls with precocious puberty: involvement of CRP and cortisol
- The relationship between the olfactory bulb and precocious puberty: from the nose to the pituitary
- Short Communication
- Experience with intramuscular glucagon for infants with early neonatal hypoglycemia
- Case Reports
- A novel GATA6 variant in a boy with neonatal diabetes and diaphragmatic hernia: a familial case with a review of the literature
- Nephrogenic diabetes insipidus in a 15-year-old Hispanic female with a novel AQP2 mutation
- Pediatric stroke as the presenting symptom of new-onset type 1 diabetes mellitus without DKA: case report and literature review
- Panhypopituitarism from neurosarcoidosis in an adolescent: case report and literature review
Articles in the same Issue
- Frontmatter
- Original Articles
- Association of the 3′UTR polymorphism (rs11665896) in the FGF21 gene with metabolic status and nutrient intake in children with obesity
- Future glycemic control of children diagnosed with type 1 diabetes mellitus at toddler and preschool/school age
- Children with type 1 diabetes of early age at onset – immune and metabolic phenotypes
- Determination of cerebral edema with serial measurement of optic nerve sheath diameter during treatment in children with diabetic ketoacidosis: a longitudinal study
- Association between inflammation, oxidative stress, vitamin D, copper and zinc with pre-obesity and obesity in school children from the city of Podgorica, Montenegro
- Phenotypic diversity and correlation with the genotypes of pseudohypoaldosteronism type 1
- Start low, go slowly – mental abnormalities in young prolactinoma patients under cabergoline therapy
- Primary ovarian insufficiency in an adolescent population: clinical phenotype and diagnostic approach
- Novel combined insulin-like 3 variations of a single nucleotide in cryptorchidism
- Evaluation of the abdominopelvic region using MRI in patients with primary amenorrhea
- Benefits of aerobic training in girls with precocious puberty: involvement of CRP and cortisol
- The relationship between the olfactory bulb and precocious puberty: from the nose to the pituitary
- Short Communication
- Experience with intramuscular glucagon for infants with early neonatal hypoglycemia
- Case Reports
- A novel GATA6 variant in a boy with neonatal diabetes and diaphragmatic hernia: a familial case with a review of the literature
- Nephrogenic diabetes insipidus in a 15-year-old Hispanic female with a novel AQP2 mutation
- Pediatric stroke as the presenting symptom of new-onset type 1 diabetes mellitus without DKA: case report and literature review
- Panhypopituitarism from neurosarcoidosis in an adolescent: case report and literature review
