Definition

Alcoholic ketoacidosis is the build up 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.

Causes, incidence, and risk factors

Alcoholic ketoacidosis is caused by excessive alcohol use. It is most often seen in a malnourished person who drinks large amounts of alcohol every day.

Symptoms

• Abdominal pain
• Agitation
• Altered level of alertness, which may lead to coma (unresponsiveness)
• Confusion
• Fatigue
• Slow, sluggish, lethargic movement
• Irregular deep, rapid breathing (Kussmaul's sign)
• Loss of appetite
• Nausea and vomiting
• Symptoms of dehydration, such as dizziness and light-headedness

Signs and tests

• Arterial blood gases
• Blood alcohol level
• Blood chemistries, such as CHEM-20
• Toxicology (poison) screening
• Urine ketones

Treatment

Treatment may involve fluids (salt and sugar solution) given through a vein. You may need to have your blood taken frequently.

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.

Complications

This can be a life-threatening disorder. Patients with alcoholic ketoacidosis often have or develop gastrointestinal bleeding, pancreatitis (inflammation of the pancreas), and pneumonia.

Calling your health care provider

If you or someone else has symptoms of alcoholic ketoacidosis, seek emergency medical help.

Prevention

Limiting the amount of alcohol you drink may help prevent this condition.

References

Cho 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.