Tuberc Respir Dis.  2006 May;60(5):548-553.

The Clinical Manifestations of Patients with Severe Alcoholic Ketoacidosis Treated at a Medical Intensive Care Unit

• Lee KH
• Lee SH
• Oh YM
• Shim TS
• Lim CM
• Lee SD
• Koh Y
• Kim WS
• Kim DS
• Kim WD
• Hong SB

Abstract

BACKGROUND: Alcoholic ketoacidosis(AKA) is a metabolic disturbance that is caused by prolonged and excessive alcohol consumption. Though the prognosis is reportedly good, its outcome is unclear in some cases that are combined with multi-organ failure. There are few reports of an analysis of cases admitted to an intensive care unit(ICU) METHOD: Cases of AKA admitted to the ICU over the last 5 years were retrospectively analyzed. Severe AKA was characterized by multi-organ failure that required treatment in an ICU
RESULTS
All patients were males with a history of excessive alcohol consumption. Five of them (50%) mainly complained of gastrointestinal symptoms (nausea, vomiting, diarrhea), showing metabolic acidosis with an increased asmolar and anion gap. Rhabdomyolysis with acute renal failure was the most common combined organ failure. Mechanical ventilation was performed in 80%. Six patients died and 4 patients survived. In the surviving patients, the arterial blood gas analysis(ABGA) was normalized within 12 hours after admission.
CONCLUSION
In severe AKA patients, rhabdomyolysis with acute renal failure was the most common complication. The mortality rate was high and death from shock occurred within 3 days.

Keyword

Alcoholic ketoacidosis; Multi-organ failure; Rhabdomyolysis; ICU

MeSH Terms

Acid-Base Equilibrium
Acidosis
Acute Kidney Injury
Alcohol Drinking
Alcoholics*
Humans
Intensive Care Units*
Critical Care*
Ketosis*
Male
Mortality
Prognosis
Respiration, Artificial
Retrospective Studies
Rhabdomyolysis
Shock
Vomiting

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