Dialysis disequilibrium syndrome: an unusual cause of respiratory failure in the medical intensive care unit.
We describe a case of the dialysis disequilibrium syndrome (DDS) that was marked by the rapid onset of cerebral edema and the subsequent development of acute respiratory failure. The patient was treated successfully with a combination of mechanical hyperventilation and mannitol. The clinical presentation, pathogenesis, prevention and treatment of the entity are discussed.
DiFresco
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Department of Medicine, New England Medical Center, Tufts University School of Medicine, Tupper Research Institute, Boston, MA 02111, USA.
Landman
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Jaber
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BL
White
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AC
D000208:Acute Disease; D000328:Adult; D001929:Brain Edema / Q000150:complications / Q000209:etiology*; D004234:Diuretics, Osmotic / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008353:Mannitol / Q000627:therapeutic use*; D006435:Renal Dialysis / Q000009:adverse effects*; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000209:etiology* / Q000628:therapy*; D013577:Syndrome; D016896:Treatment Outcome
D004234:Diuretics, Osmotic; D008353:Mannitol