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

Lee, Kwang Ha (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Lee, Sae Hwan (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Oh, Yeon-Mok (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Shim, Tae Sun (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Lim, Chae-Man (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Lee, Sang Do (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Koh, Yoonsuck (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Kim, Woo Sung (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Kim, Dong Soon (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Kim, Won Dong (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Hong, Sang Bum (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Publication Information
Tuberculosis and Respiratory Diseases / v.60, no.5, 2006 , pp. 548-553 More about this Journal
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.
Keywords
Alcoholic ketoacidosis; Multi-organ failure; Rhabdomyolysis; ICU;
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