Routine clinical assays for ketonemia test for AcAc and acetone but not for β-OH. Clinicians underestimate the degree of ketonemia if they rely solely on the results of laboratory testing. Prolonged vomiting leads to dehydration, which decreases renal perfusion, thereby limiting urinary excretion of ketoacids.
Risk factors
Your doctor and other medical professionals will watch you for symptoms of withdrawal. Alcoholic ketoacidosis may lead to gastrointestinal bleeding. Your doctor may also admit you to the intensive care unit (ICU) if you require ongoing care. The length of your hospital stay depends on the severity of the alcoholic ketoacidosis.
- Alcoholic ketoacidosis is the buildup of ketones in the blood due to alcohol use.
- The evaluation consists of 11 yes or no questions that are intended to be used as an informational tool to assess the severity and probability of an alcohol use disorder.
- The condition is an acute form of metabolic acidosis, a condition in which there is too much acid in body fluids.
- The patient should have blood glucose checked on the initial presentation.
- To get the energy you need, your body will start to burn fat.
Alcoholic Ketoacidosis Treatment and Diagnosis
The accompanying lack of alcohol in the patient's body and the fact that for some time, the only source of calories that a patient has is ethanol both contribute to the clinical syndrome that we see. If you develop any of these symptoms, seek emergency medical attention. Sometimes, diabetic ketoacidosis can occur with type 2 diabetes.
What are the complications of alcoholic ketoacidosis?
Alcoholic ketoacidosis (AKA) is a condition seen commonly in patients with alcohol use disorder or after a bout of heavy drinking. It is a clinical diagnosis with patients presenting with tachycardia, tachypnea, dehydration, agitation, and abdominal pain. This activity illustrates the evaluation and treatment of alcoholic ketoacidosis and explains the role of the interprofessional team in managing patients with this condition.
- Decreased insulin and elevated glucagon, cortisol, catecholamine, and growth hormone levels can increase the rate of ketogenesis.
- Cirrhosis of the liver can cause exhaustion, leg swelling, and nausea.
- Without insulin, your cells won’t be able to use the glucose you consume for energy.
- You should also follow all of your doctor’s recommendations to ensure proper nutrition and recovery.
Generally, the physical findings relate to volume depletion and chronic alcohol abuse. Typical characteristics of the latter may include rhinophyma, tremulousness, hepatosplenomegaly, peripheral neuropathy, gynecomastia, testicular atrophy, and palmar erythema. The patient might be tachycardic, tachypneic, alcoholic ketoacidosis profoundly orthostatic, or frankly hypotensive as a result of dehydration from decreased oral intake, diaphoresis, and vomiting. Several mechanisms are responsible for dehydration, including protracted vomiting, decreased fluid intake, and inhibition of antidiuretic hormone secretion by ethanol.
In general, the prognosis for a patient presenting with AKA is good as long as the condition is identified and treated early. The major cause of morbidity and mortality in patients diagnosed with AKA is under-recognition of concomitant diseases (that may have precipitated the AKA, to begin with). These include acute pancreatitis, gastrointestinal bleeding, and alcohol withdrawal. Mortality specifically due to AKA has been linked to the severity of serum beta-hydroxybutyric acid in some studies.
