title: Acute Respiratory Distress Syndrome: A Rare Complication in Pediatric Diabetic Ketoacidosis.
abstract: Cerebral edema (CE) and non cardiogenic pulmonary edema (acute respiratory distress syndrome, ARDS) are life-threatening complications of diabetic ketoacidosis (DKA). In contrast to CE complicating DKA, which is primarily reported in pediatric patients, ARDS is rarely described in this age group. Here, the authors present a child with DKA who developed both cerebral edema and ARDS during the course of her management. It is feasible that severe acidosis, hypotension, azotemia, hypoalbuminemia and the superimposed aggressive intravenous fluid administration were important risk factors for the development of cerebral edema and ARDS in the index patient. The report highlights the importance of early diagnosis and aggressive therapy in the management of ARDS, and summarizes the published literature on this rarely reported complication of pediatric DKA.
authors.affiliation: Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, Uttar Pradesh, India.
authors.forename: Siddhnath
authors.initials: S
authors.lastname: Sudhanshu
authors.affiliation: Division of Endocrinology and Diabetes, Medanta the Medicity, Gurgaon, Haryana, India.
authors.forename: Ganesh
authors.initials: G
authors.lastname: Jevalikar
authors.affiliation: Department of Anesthesiology, Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Pravin K
authors.initials: PK
authors.lastname: Das
authors.affiliation: Department of Anesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Pramod K
authors.initials: PK
authors.lastname: Singh
authors.affiliation: Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, Uttar Pradesh, India.
authors.forename: Eesh
authors.initials: E
authors.lastname: Bhatia
authors.affiliation: Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, Uttar Pradesh, India. bhatiaviji@gmail.com.
authors.forename: Vijayalakshmi
authors.initials: V
authors.lastname: Bhatia
mesh_terms: D000293:Adolescent; D001929:Brain Edema / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D016883:Diabetic Ketoacidosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D004234:Diuretics, Osmotic / Q000008:administration & dosage; D042241:Early Diagnosis; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology; D008353:Mannitol / Q000008:administration & dosage*; D009460:Neurologic Examination / Q000379:methods; D011859:Radiography / Q000379:methods; D006435:Renal Dialysis / Q000379:methods*; D012121:Respiration, Artificial / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D004234:Diuretics, Osmotic; D008353:Mannitol
keywords: ARDS; Cerebral edema; DKA; Mannitol; Pediatric