Alcoholic Ketoacidosis StatPearls NCBI Bookshelf

Arterial blood gas – The blood gas analysis will most likely reveal a pH that is low or normal. The presence of a mixed disorder may also be present as significant vomiting can cause metabolic alkalosis. Complete blood count – The white blood cell count , hemoglobin, and hematocrit levels may be elevated in a dehydrated patient.

alcoholic ketoacidosis treatment guidelines

The onset and severity of clinical and laboratory abnormalities depends largely on the generation of formic acid . Visual disturbances, including decreased visual acuity, photophobia, and blurred vision, and abdominal pain are the most common symptoms of methanol intoxication , one or both being found in 37 to 72% of patients . Hyperemia of the optic disks and a reduced papillary response to light may be present. The severity of the visual abnormalities is directly correlated with the severity of the metabolic acidosis . Although most patients will recover normal visual function, permanent impairment of vision has been observed in from 11 to 18% of patients . In general, exogenous insulin is contraindicated in the treatment of AKA, because it may cause life-threatening hypoglycemia in patients with depleted glycogen stores. In most cases, the patient’s endogenous insulin levels rise appropriately with adequate carbohydrate and volume replacement.


Patients develop acidosis, which causes an increase in respirations and fluid loss. Alcoholic ketoacidosis treatment may involve fluids given through a vein. You may get vitamin supplements to treat nutritional deficiencies caused by excess alcohol use. Hemodialysis is effective in rapidly lowering ethylene glycol levels and removing glycolate . The mean clearance rate of ethylene glycol is approximately 145 to 230 ml/min. The duration of hemodialysis necessary to reduce ethylene glycol concentrations can be estimated using the formula described by Hirsch et al. . Glycolate clearance is approximately 60% of urea clearance , and hemodialysis was shown to reduce its elimination half-life by more than four-fold .

Do You Ask Whether Your Patient Drinks? – Medscape

Do You Ask Whether Your Patient Drinks?.

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If the patient’s blood glucose level is significantly elevated, AKA may be indistinguishable fromdiabetic ketoacidosis. Suspect alcoholic ketoacidosis in any patient with recent binge drinking and an elevated anion gap.

Annals of Medicine and Surgery

Diagnosis is made in the appropriate clinical setting and is based on laboratory evaluation. Laboratory evaluation should include CBC; electrolyte alcoholic ketoacidosis panel with calcium, phosphate, and magnesium; ethanol, methanol, and isopropyl alcohol levels; hepatic enzymes; lipase; and serum ketones.

Can DKA cause sudden death?

Diabetic ketoacidosis (DKA) is life-threatening—learn the warning signs to be prepared for any situation. DKA is no joke, it's a serious condition that can lead to diabetic coma or even death. DKA is caused by an overload of ketones present in your blood.

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