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Case Reports
Hyperemia and impaired cerebral autoregulation in a surgical patient with diabetic ketoacidosis.
- Monica S Vavilala, Michael J Souter, and Arthur M Lam.
- Department of Anesthesiology, Harborview Medical Center, 325 Ninth Avenue, Box 359724, Seattle, Washington 98104, USA. vavilala@u.washington.edu
- Can J Anaesth. 2005 Mar 1;52(3):323-6.
PurposeWe describe cerebral hyperemia and impaired cerebral autoregulation documented with transcranial Doppler (TCD) ultrasonography in an adult patient with diabetic ketoacidosis (DKA) and sepsis presenting for surgery.Clinical FeaturesMiddle cerebral artery flow velocity was increased relative to PaCO(2) (Vmca 52 cm.sec(-1); PaCO(2) 22 mmHg) and the autoregulatory index (ARI) was 0 prior to surgery. Twenty hours after admission and treatment, cerebral hyperemia resolved (Vmca 52 cm.sec(-1) ; PaCO(2) 35 mmHg) and cerebral autoregulation returned to normal (ARI 0.91).ConclusionTo our knowledge, this is the first description of impaired cerebral autoregulation in adult DKA. Our observations suggest a relationship between cerebral hyperemia and impaired cerebral autoregulation in DKA.
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