Cerebral edema complicating diabetic ketoacidosis in childhood

Three patients who developed fatal cerebral edema in the diabetes camp setting were reviewed with 14 previously reported instances in persons under 21 years of age. Seven occurred in the initial episode of diabetic ketoacidosis. Minimal blood glucose levels less than 250 mg/dl were recorded in 8/17. Rate of fluid administration, rate of Na or K infusion, and hyponatremia or hypokalemia were not consistent factors. Two of the 17 patients received oral fluids only. An etiologic role for rate of blood glucose correction or speed of hydration was not substantiated by this experience and review.