Cerebral Edema in Children and Adolescents with Diabetic Ketoacidosis: Pathophysiological Mechanisms and Clinical Presentation

INTRODUCTION: Diabetic ketoacidosis (DKA) is one of the acute and severe complications of type 1 diabetes mellitus in pediatric practice. AIM: To analyzed based on literature data the key pathophysiological mechanisms and clinical features of cerebral edema (CE) in children and adolescents with DKA. The paper describes the results of foreign and domestic studies dedicated to the mechanisms of development, clinical features of CE in pediatric practice. Topic-related sources from the PubMed and RSCI databases are reviewed. The search depth is 25 years. CONCLUSION: Reviewed are the pathogenetic mechanisms underlying the development of cytotoxic, vasogenic and osmotic CE. Particular emphasis is made on the inflammation theory and the role of ischemic/hypoxic factors in the development of CE. Data are provided to describe specific clinical features of CE in children and adolescents receiving intensive care, as well as risk factors that predispose to the development of this complication. Understanding of the pathogenetic mechanisms, clinical signs CE will result in better treatment outcomes and bring down the risk of death in this category of patients.