Tuberc Respir Dis > Volume 60(5); 2006 > Article
Tuberculosis and Respiratory Diseases 2006;60(5):548-553.
DOI: https://doi.org/10.4046/trd.2006.60.5.548    Published online May 1, 2006.
The Clinical Manifestations of Patients with Severe Alcoholic Ketoacidosis Treated at a Medical Intensive Care Unit.
Kwang Ha Lee, Sae Hwan Lee, Yeon Mok Oh, Tae Sun Shim, Chae Man Lim, Sang Do Lee, Yoonsuck Koh, Woo Sung Kim, Dong Soon Kim, Won Dong Kim, Sang Bum Hong
Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.sbhong@amc.seoul.kr
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.
Key Words: Alcoholic ketoacidosis, Multi-organ failure, Rhabdomyolysis, ICU


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