DefinitionAlcoholic 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 NamesKetoacidosis - alcoholic
Causes, incidence, and risk factorsAlcoholic ketoacidosis is caused by excessive alcohol use. It is most often seen in a malnourished person who drinks large amounts of alcohol every day.
SymptomsAbdominal painAgitationChanged level of alertness, which may lead to comaConfusionFatigueSlow, sluggish, lethargic movementIrregular deep, rapid breathing (Kussmaul's sign)Loss of appetiteNausea and vomitingSymptoms of dehydration, such as dizziness, light-headedness, and thirst
Signs and testsArterial blood gases (measure the acid/base balance and oxygen level in blood)Blood alcohol levelBlood chemistries, such as CHEM-20Toxicology (poison) screeningUrine ketones
TreatmentTreatment 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).
Expectations (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.
ComplicationsThis can be a life-threatening disorder. Complications can include:Gastrointestinal bleedingPancreatitis (inflammation of the pancreas)Pneumonia
Calling your health care providerIf you or someone else has symptoms of alcoholic ketoacidosis, seek emergency medical help.
PreventionLimiting the amount of alcohol you drink may help prevent this condition.
ReferencesCho 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.