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Change in blood-brain barrier permeability during pediatric diabetic ketoacidosis treatment

Monica S Vavilala1, Todd L Richards, Joan S Roberts

  • 1Department of Anesthesiology, University of Washington, Seattle, WA, USA. Vavilala@u.washington.edu

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|October 20, 2009
PubMed

Insights

Blood-brain barrier permeability increased in children during treatment for diabetic ketoacidosis. The frontal brain region showed the most significant increase in permeability.

Area of Science:

  • Pediatric neurology
  • Neuroscience
  • Endocrinology

Background:

  • Cerebral edema is a serious complication of pediatric diabetic ketoacidosis.
  • Understanding blood-brain barrier (BBB) function during treatment is crucial.

Purpose of the Study:

  • To investigate changes in blood-brain barrier permeability during the treatment of diabetic ketoacidosis in children.

Main Methods:

  • Prospective observational study involving 13 children with diabetic ketoacidosis.
  • Serial contrast-enhanced perfusion and diffusion MRI scans were performed.
  • Blood-brain barrier permeability was assessed using permeability ratio and % permeability ratio change.

Main Results:

  • Blood-brain barrier permeability increased from initial treatment to recovery in most subjects.
  • Whole brain permeability ratio increased by 160%.
  • The frontal cortex exhibited the greatest regional increase in permeability (148%).

Conclusions:

  • Blood-brain barrier permeability generally increases during diabetic ketoacidosis treatment in children.
  • The frontal brain region demonstrates higher permeability compared to other examined areas.
Abstract

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