ArticleDiabetes therapy : research, treatment and education of diabetes and related disorders2019
Excessive Sodium Bicarbonate Infusion May Result in Osmotic Demyelination Syndrome During Treatment of Diabetic Ketoacidosis: A Case Report.
Article in Diabetes therapy : research, treatment and education of diabetes and related disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 9 citations in OpenAlex.
- Osmotic Demyelination Syndrome in the Setting of Normonatremia: A Case Report and Review of the Literature.Case reports in neurological medicine · 2024Article
- Article
- Central pontine myelinolysis mimicking glioma in diabetes: A case report.World journal of clinical cases · 2021Article
- Article
- Comment on "Excessive Sodium Bicarbonate Infusion May Result in Osmotic Demyelination Syndrome During Treatment of Diabetic Ketoacidosis: A Case Report" by Hsieh et al.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2019Article
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4 authors at 1 institution in 1 country.
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Abstract
introductionWe present a case wherein diabetic ketoacidosis (DKA) was treated with a large amount of sodium bicarbonate and potassium chloride, resulting in the development of osmotic demyelination syndrome (ODS). CASE PRESENTATION: Our patient was a 29-year-old male with a history of post-surgical repair for ventricular septal defect. Upon arrival, the patient's Glasgow Coma Scale (GCS) score was E2M4V3. Laboratory examinations revealed leukocytosis, severe metabolic acidosis, hypokalemia, and hyperglycemia. His consciousness status and hemodynamics improved after resuscitation (GCS: E3M6Ve). However, they declined at the 40th hour of admission and dropped to GCS E2M2Ve. Magnetic resonance imaging revealed multifocal abnormal signal intensity changes in the whole brain stem. The diagnosis of type 1 diabetes mellitus was made during the hospitalization period. The patient exhibited improved consciousness status after 17-day medical care at the ICU.
conclusionsWe recommend that in the case of DKA, the correction of hypokalemia should be prioritized during treatment. Sodium bicarbonate infusion should be reserved for pH < 6.9. In addition, close monitoring of the serum sodium level and prompt actions to lower it if it exceeds the threshold may be necessary.
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