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

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

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.

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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