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Question |
dear netters > a 9 yr old female is admitted in hospital & she > is k\c diabetic ketoacidosis with diffuse brain > damage. she had cardiac arrest & resuscitate > succesfully.Tracheostomy was done at appolo hospital > delhi & pt on ventilator & unable to wean off because > as we remove the ventilator,respiraory distress > occured. > In present status pt. had decerebrate > posturing on & off & requires insulin drip to maintain > the blood sugar & no chage was noted in cns status.EEG > suggestive of generalized slowing with diffuse brain > damage > any one can suggest regarding further > managment & prognosis. > > dear netters > a 9 yr old female is admitted in hospital & she > is k\c diabetic ketoacidosis with diffuse brain > damage. she had cardiac arrest & resuscitate > succesfully.Tracheostomy was done at appolo hospital > delhi & pt on ventilator & unable to wean off because > as we remove the ventilator,respiraory distress > occured. > In present status pt. had decerebrate > posturing on & off & requires insulin drip to maintain > the blood sugar & no chage was noted in cns status.EEG > suggestive of generalized slowing with diffuse brain > damage > any one can suggest regarding further > managment & prognosis
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Answer |
Try and get a neuroimaging done to find out the cause of her brain damage. If due to diabetic ketoacidosis it may show changes due to osmolar damage (myelinolysis. If due to infection, there may be features suggestive of encephalitis. Also make sure her metabolic parameters are stable for a few days before trying to wean her off the ventilator.
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