ArticlePediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2010
Change in blood-brain barrier permeability during pediatric diabetic ketoacidosis treatment.
Article in Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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19 citing papers in PubMed, 57 citations in OpenAlex.
- Diabetic Ketoacidosis-Associated Brain Injury: A Rare but Serious Complication.JCEM case reports · 2025Article
- Correlation between Neutrophil-to-Lymphocyte Ratio and Cerebral Edema in Children with Severe Diabetic Ketoacidosis.Biomedicines · 2023Article
- Pediatric Hyperglycemic Hyperosmolar Syndrome: A Comprehensive Approach to Diagnosis, Management, and Complications Utilizing Novel Summarizing Acronyms.Children (Basel, Switzerland) · 2023Review
- Effects of Diabetes Mellitus-Related Dysglycemia on the Functions of Blood-Brain Barrier and the Risk of Dementia.International journal of molecular sciences · 2023Review
- Brain injury in children with diabetic ketoacidosis: Review of the literature and a proposed pathophysiologic pathway for the development of cerebral edema.Pediatric diabetes · 2021Review
- Article
- Leptin receptor deficiency induces early, transient and hyperglycaemia-independent blood-brain barrier dysfunction.Scientific reports · 2019Article
- Subclinical cerebral edema in diabetic ketoacidosis in children.Clinical case reports · 2019Article
- Article
- Optic Nerve Sheath Diameter Measurement During Diabetic Ketoacidosis: A Pilot Study.The western journal of emergency medicine · 2016Article
- Optic Nerve and Cerebral Edema in the Course of Diabetic Ketoacidosis.Current neuropharmacology · 2016Review
- EDITORIAL (Thematic Issue: Retinal Neurodegeneration in the Course of Diabetes: Neuroprotection as a Potential Treatment Target).Current neuropharmacology · 2016Article
- Fluid management in pediatric patients with DKA and rates of suspected clinical cerebral edema.Pediatric diabetes · 2015Article
- Effects of metabolic acidosis on intracellular pH responses in multiple cell types.American journal of physiology. Regulatory, integrative and comparative physiology · 2014Article
- Cerebrovascular autoregulation in diabetic ketoacidosis: time to go with the (microvascular cerebral blood) flow!Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2014Article
- Diabetes Mellitus and Blood-Brain Barrier Dysfunction: An Overview.Journal of pharmacovigilance · 2014Article
- Treating cerebral edema in diabetic ketoacidosis: caveats in extrapolating from traumatic brain injury*.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2013Article
- Change in mean transit time, apparent diffusion coefficient, and cerebral blood volume during pediatric diabetic ketoacidosis treatment.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2011Article
- Biomarkers and genetics of brain injury risk in diabetic ketoacidosis: A pilot study.Journal of pediatric intensive careArticle
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9 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveCerebral edema is a devastating complication of pediatric diabetic ketoacidosis. We aimed to examine blood-brain barrier permeability during treatment of diabetic ketoacidosis in children.
designProspective observational study.
settingSeattle Children's Hospital, Seattle, WA. PATIENTS: Children admitted with diabetic ketoacidosis (pH <7.3, HCO3 <15 mEq/L, glucose >300 mg/dL, and ketosis).
interventionsNone. MEASUREMENTS AND MAIN
resultsSubjects underwent two serial paired contrast-enhanced perfusion (gadolinium) and diffusion magnetic resonance imaging scans. Change in whole brain and regional blood-brain barrier permeability (permeability ratio*100 and % permeability ratio change) between illness and recovery were determined. Time 0 reflects start of insulin treatment. Thirteen children (median age 10.0 +/- 1.1 yrs; seven female) with diabetic ketoacidosis were enrolled. Permeability ratio increased from time 1 (first magnetic resonance image after time 0) to time 2 (second magnetic resonance image after time 0) in the frontal cortex (ten of 13 subjects), occipital cortex (ten of 13 subjects), and basal ganglia (nine of 13). Whole brain permeability ratio increased from time 1 to time 2 (160%) and regional increase in permeability ratio was greatest in the frontal cortex (148%) compared with the occipital cortex (128%) and basal ganglia (112%).
conclusionsOverall, whole brain and regional blood-brain barrier permeability increased in most subjects during diabetic ketoacidosis treatment. The frontal region had more blood-brain barrier permeability than other brain regions examined.
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