Risk Factors for Cerebral Edema in Children With Diabetic Ketoacidosis. The Pediatric Emergency Medicine Collaborative Research Committee of the American Academy of Pediatrics (NEJM 2001)

Cerebral edema is an uncommon but devastating complication of diabetic ketoacidosis in children. Risk factors for this complication have not been clearly defined prior to this study.

In this multicenter study, the group identified 61 children who had been hospitalized for diabetic ketoacidosis within a 15-year period and in whom cerebral edema had developed. Their course was studied to identify demographic characteristics and biochemical variables at presentation, therapeutic interventions and changes in biochemical values during treatment.

It was concluded that children with diabetic ketoacidosis who have low partial pressures of arterial carbon dioxide and high serum urea nitrogen concentrations at presentation and who are treated with bicarbonate are at increased risk for cerebral edema.