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Alcoholic ketoacidosis

Alcoholic ketoacidosis is the buildup of ketones in the blood. Ketones are a type of acid that form when the body breaks down fat for energy.

The condition is an acute form of metabolic acidosis .

Alternative Names

Ketoacidosis - alcoholic

Causes

Alcoholic ketoacidosis is caused by excessive alcohol use. It is most often seen in a malnourished person who drinks large amounts of alcohol every day.

Symptoms

  • Abdominal pain
  • Agitation
  • Changed level of alertness, which may lead to coma
  • Confusion
  • Fatigue
  • Slow, sluggish, lethargic movement
  • Irregular deep, rapid breathing (Kussmaul's sign)
  • Loss of appetite
  • Nausea and vomiting
  • Symptoms of dehydration , such as dizziness, light-headedness, and thirst

Exams and Tests

  • Arterial blood gases (measure the acid/base balance and oxygen level in blood)
  • Blood alcohol level
  • Blood chemistries, and liver function tests, such as CHEM-20
  • CBC (complete blood count, measures red and whilte blood cells, and platelets, which help blood to clot)
  • Prothrombin time (PT, a different measure of blood clotting, often abnormal from liver disease)
  • Toxicology (poison) screening
  • Urine ketones

Treatment

Treatment may involve fluids (salt and sugar solution) given through a vein. You may need to have your blood taken often. You may get vitamin supplements to treat nutritional deficiencies caused by excess alcohol use.

People with this condition are admitted to the hospital, often to the intensive care unit (ICU). Additional medications may be given to prevent alcohol withdrawal.

Outlook (Prognosis)

Prompt medical attention improves the overall outlook. How severe the alcoholism is, and the presence of liver disease or other complications also affect the outlook.

Possible Complications

This can be a life-threatening disorder. Complications can include:

When to Contact a Medical Professional

If you or someone else has symptoms of alcoholic ketoacidosis, seek emergency medical help.

Prevention

Limiting the amount of alcohol you drink may help prevent this condition.

References

Cho KC, Fukagawa M, Kurokawa K. Fluid and electrolyte disorders. In: McPhee SJ, Papadakis MA, eds. Current Medical Diagnosis and Treatment. 48th ed. New York, NY: McGraw-Hill; 2009:chap 21.

DuBose TD Jr. Acidosis and alkalosis. In: Fauci A , Kasper D, Longo DL, et al, eds. Harrison's Principals of Internal Medicine. 17th ed. New York, NY: McGraw Hill; 2008:chap 48.

Wiener SW, Hoffman RS. Alcoholic ketoacidosis. In: Wolfson AB, Hendey GW, Ling LJ, et al, eds. Harwood-Nuss' Clinical Practice of Emergency Medicine. 5th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2009:chap 25.

Updated: 4/5/2013

Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.


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