Journal List > Tuberc Respir Dis > v.60(5) > 1000951

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Lee, Lee, Oh, Shim, Lim, Lee, Koh, Kim, Kim, Kim, and Hong: The Clinical Manifestations of Patients with Severe Alcoholic Ketoacidosis Treated at a Medical Intensive Care Unit
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2006; 60(5): 548-553.

Published online: 31 May 2006

DOI: https://doi.org/10.4046/trd.2006.60.5.548

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

Kwang Ha Lee, M.D., Sae Hwan Lee, M.D., Yeon-Mok Oh, M.D., Tae Sun Shim, M.D., Chae-Man Lim, M.D., Sang Do Lee, M.D., Yoonsuck Koh, M.D., Woo Sung Kim, M.D., Dong Soon Kim, M.D., Won Dong Kim, M.D., Sang Bum Hong, M.D.

Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Address for correspondence: Sang-Bum Hong, M.D. Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnap-2dong, Songpa-gu, Seoul 138-736, Korea. Phone: 02-3010-3893, FAX: 02-3010-6968, sbhong@amc.seoul.kr

Received 6 February 2006       Accepted 25 April 2006

Copyright © 2006 The Korean Academy of Tuberculosis and Respiratory Diseases

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)

Methods

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.

Keywords: Alcoholic ketoacidosis, Multi-organ failure, Rhabdomyolysis, ICU

Figures and Tables

Table 1
Laboratory findings and outcome of each patient
trd-60-548-i001

* + : Alive, - : Dead

Table 2
Comparision of laboratory findings between non-survival and survival
trd-60-548-i002

APACHE II* : Acute Physiology And Chronic Health Evaluation II

SOFA†: Sequential Organ Failure Assessment

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