Cerebral Edema and Refeeding Syndrome, Complications of Severe Ketoacidosis in Type 1 Diabetes Mellitus
Keywords:
diabetic ketoacidosis, Mellitus diabetes, Feedback syndrome, cerebral edema.Abstract
Introduction: In most cases, diabetic ketoacidosis is the onset of type 1 diabetes mellitus. Among its complications are cerebral edema, mainly responsible for high morbidity and mortality, and refeeding syndrome, a hydroelectrolyte disorder that occurs in patients at risk of malnutrition or malnourished and that represents a threat to their life. Objective: To report the case of a preschool patient with diabetic ketoacidosis at the beginning of her disease, and complications such as refeeding syndrome and cerebral edema. Case report: The previously healthy two-year-old preschool patient was admitted with severe and stuporous dehydration. Laboratories reported hyperglycemia, severe metabolic acidosis with elevated anion gap, hypocapnia, glycosuria, ketonuria, normal corrected sodium, and hypokalemia. The diagnosis of severe diabetic ketoacidosis was confirmed. Computed axial tomography showed cerebral edema. The patient was admitted to the Pediatric Intensive Care Unit. Oral administration was started on the fourth day of stay. She developed refeeding syndrome. The oral route was suspended and treatment with parenteral nutrition started. After subsequent improvement, she was discharged with comprehensive outpatient treatment for type 1 diabetes mellitus. Conclusions: Diabetic ketoacidosis acts as a factor to develop refeeding syndrome. It is necessary to maintain close monitoring of alterations related to serum electrolytes at the beginning of oral administration.Downloads
References
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