**8. Treatment of cerebral edema [1,2,4]**


after the start of treatment. Symptoms and signs are variable. A method of clinical diagnosis

**•** Abnormal neurogenic respiratory pattern (e.g., grunting, tachypnea, Cheyne-Stokes respi‐

**•** Sustained heart rate deceleration (decrease more than 20 beats per minute) not attributa‐

One diagnostic criterion, two major criteria, or one major and two minor criteria have a sen‐

A chart with the reference ranges for blood pressure and heart rate, which vary depending on height, weight, and gender, should be readily available, either in the patient's chart or at

**•** Start as early as you suspect the condition, do not delay treatment until radiographic evi‐

**•** Restrict IV fluids to 2/3 maintenance and replace deficit over 72 hr rather than 24 hr

based on bedside evaluation of neurological state is shown below [23]:

**7.2. Diagnostic criteria**

308 Type 1 Diabetes

ration, apneusis)

*7.2.1. Major criteria*

*7.2.2. Minor criteria*

**•** Vomiting **•** Headache

**•** Age <5 years

the bedside.

dence

**•** Abnormal motor or verbal response to pain

**•** Cranial nerve palsy (especially III, IV, and VI)

**•** Altered mentation/fluctuating level of consciousness

ble to improved intravascular volume or sleep state

**•** Decorticate or decerebrate posture

**•** Age-inappropriate incontinence

**•** Lethargy or not easily arousable

**•** Diastolic blood pressure >90 mm Hg

sitivity of 92% and a false positive rate of only 4%.

**8. Treatment of cerebral edema [1,2,4]**

**•** Transfer to the ICU (if not already there)

