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diabetic ketoacidosis DKA

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Text of diabetic ketoacidosis DKA

  1. 1. Diabetic ketoacidosis Presented by : Yusor jaafar Supervised by : Dr.Haider
  2. 2. Difinition Hyperglycemia (blood glucose >11 mmol/L [200 mg/dL]) Venous pH 10 mL/kg/h,at rate of 0.5 mmol/kg/hr.
  3. 33. Bicarbonate
  4. 34. Because 1)cause intracelluler acidosis 2)increase risk of cerebral oedema because increase sodium leve in plasma (hypernatremia) 3)cause cellular hypoxia and hypokalemia
  5. 35. Bicarbonate administration in : 1)patients with severe acidemia (arterial pH 50cc/ kg in first 4 hrs) Bicarbonate therapy for correction of acidosis Insulin administration in the first hour of therapy
  6. 45. Changes in biochemical values during treatment Severe Hypernatremia Persistent hyponatremia An attenuated rise in measured serum sodium concentrations during therapy Non closure of the anion gap
  7. 46. Diagnostic criteria Abnormal motor or verbal response to pain Decorticate or decerebrate posture Cranial nerve palsy (especially III, IV, and VI) Abnormal neurogenic respiratory pattern (e.g., grunting, tachypnea, Cheyne-Stokes respiration, apneusis )
  8. 47. Major criteria Altered mentation/fluctuating level of consciousness Sustained heart rate deceleration (decrease more than 20 beats per minute) not attributable to improved intravascular volume or sleep state Age-inappropriate incontinence
  9. 48. Minor criteria Headache Vomiting Diastolic blood pressure >90mmhg Lethargy Age

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