Laboratory analysis plays a major role in the evaluation of a patient with suspected alcoholic ketoacidosis. Patients are usually tachycardic, dehydrated, tachypneic, present with abdominal pain, and are often agitated. People who drink large quantities of alcohol may not eat regularly. Not eating enough or vomiting can lead to periods of starvation. Alcoholic ketoacidosis can develop when you drink excessive amounts of alcohol for a long period of time.
Alcoholic Ketoacidosis Treatment and Diagnosis
In general, the prognosis for a patient presenting with AKA is good as long as the condition is identified and treated early. The major cause of morbidity and mortality in patients diagnosed with AKA is under-recognition of concomitant diseases (that may have precipitated the AKA, to begin with). These include acute pancreatitis, gastrointestinal bleeding, and alcohol withdrawal. Mortality specifically due to AKA has been linked to the severity of serum beta-hydroxybutyric acid in some studies.
How can I prevent alcoholic ketoacidosis?
- After these test results are in, they can confirm the diagnosis.
- It most often occurs in a malnourished person who drinks large amounts of alcohol every day.
- During starvation, there is a decrease in insulin secretion and an increase in the production of counter-regulatory hormones such as glucagon, catecholamines, cortisol, and growth hormone.
- Assess the patient’s airway and manage as clinically indicated.
- Neurologically, patients are often agitated but may occasionally present lethargic on examination.
Joining a local chapter of Alcoholics Anonymous may provide you with the support you need to cope. You should also follow all of your doctor’s recommendations to ensure proper nutrition and recovery. If you are diagnosed with alcoholic ketoacidosis, your recovery will depend on a number of factors.
Alcoholic Ketoacidosis Treatment & Management
Moreover, volume depletion increases the concentration of counter-regulatory hormones, further stimulating lipolysis and ketogenesis. You can prevent alcoholic ketoacidosis by limiting your alcohol intake. You can learn how to reduce your alcohol intake or eliminate it altogether.
In some cases, diabetic ketoacidosis may be the first sign of having diabetes. If indicated, provide follow-up with AKA patients to assess the problem of alcohol abuse. Consider referral to a counselor at an alcohol treatment center. Assess for clinical signs of thiamine deficiency (Wernicke-Korsakoff syndrome).
Excessive alcohol consumption often causes malnourishment (not enough nutrients for the body to function well). These agents are rarely used for the management of severe metabolic acidosis. Intravenous benzodiazepines can be administered based on the risk of seizures from impending alcohol withdrawal. Antiemetics such as ondansetron or metoclopramide may also be given to control nausea and vomiting. Your prognosis will be impacted by the severity of your alcohol use and whether or not you have liver disease.
- Prevention of AKA involves the treatment of chronic alcohol abuse.
- The long-term prognosis for the patient is influenced more strongly by recovery from alcoholism.
- The dextrose will also increase glycogen stores and diminish counterregulatory hormone levels.
- Carnitine acyltransferase (CAT) transports free fatty acids into the mitochondria and therefore regulates their entry into the oxidative pathway.
- Not eating enough or vomiting can lead to periods of starvation.
- These conditions have to be ruled out before a medical professional can diagnose you with alcoholic ketoacidosis.
What are the symptoms of alcoholic ketoacidosis?
Routine clinical assays for ketonemia test for AcAc and acetone but not for β-OH. Clinicians underestimate the degree of ketonemia if they rely solely on the results of laboratory testing. Prolonged vomiting leads to dehydration, which decreases renal perfusion, thereby limiting urinary excretion of ketoacids.
Alcoholic ketoacidosis (AKA) is a condition seen commonly in patients with alcohol use disorder or after a bout of heavy drinking. It is a clinical diagnosis with patients presenting with tachycardia, tachypnea, dehydration, alcoholic ketoacidosis agitation, and abdominal pain. This activity illustrates the evaluation and treatment of alcoholic ketoacidosis and explains the role of the interprofessional team in managing patients with this condition.
Assess the patient’s airway and manage as clinically indicated. With timely and aggressive intervention, the prognosis for a patient with AKA is good. The long-term prognosis for the patient is influenced more strongly by recovery from alcoholism. This goal can usually be achieved through the administration of dextrose and saline solutions (see Treatment). American Addiction Centers (AAC) is committed to delivering original, truthful, accurate, unbiased, and medically current information. We strive to create content that is clear, concise, and easy to understand.
