title: [Fluid management and the risk of cerebral oedema in children with diabetic ketoacidosis].
abstract: BACKGROUND
  Cerebral oedema is a rare but life-threatening complication of diabetic ketoacidosis in children.
  
  
  METHODS
  This paper presents a case report on an infant with diabetic ketoacidosis and in an extreme hyperosmolar and hypernatremic state. Considerations regarding appropriate fluid management and the osmotic role of serum sodium are discussed. Recommendations for treatment are given based on available guidelines and published evidence.
  
  
  CONCLUSIONS
  Intracellular swelling of the brain seems to be caused by water moving along osmotic gradients. In diabetic ketoacidosis, sodium and glucose are the dominant osmotic forces. It is important to understand the relation between serum osmolarity, sodium and glucose, as appropriate fluid treatment might prevent this potentially fatal complication.
authors.affiliation: Barneklinikken, Haukeland Universitetssjukehus, 5021 Bergen. ansgar.berg@pedi.uib.no
authors.forename: Ansgar
authors.initials: A
authors.lastname: Berg
authors.forename: Oddmund
authors.initials: O
authors.lastname: Søvik
authors.forename: Asle
authors.initials: A
authors.lastname: Hirth
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D001929:Brain Edema / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D016883:Diabetic Ketoacidosis / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D004234:Diuretics, Osmotic / Q000008:administration & dosage; D005440:Fluid Therapy; D006801:Humans; D007223:Infant; D008297:Male; D008353:Mannitol / Q000008:administration & dosage; D009994:Osmolar Concentration; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012965:Sodium Chloride / Q000097:blood
chemical_list: D001786:Blood Glucose; D004234:Diuretics, Osmotic; D008353:Mannitol; D012965:Sodium Chloride