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Metabolic Disorders: Alcoholic Ketoacidosis (AKA) - #MEDSHED


 


 

💀 Metabolic Disorders: Alcoholic Ketoacidosis - #MEDSHED



🍷 Chronic, binge drinking alcoholics are at highest risk for developing alcoholic ketoacidosis. Alcoholic ketoacidosis results from several factors; alcohol inhibits antidiuretic hormone, which increases urination, while N/V and abdominal pain reduces nutritional intake.



Persistently low glycogen stores eventually shifts from aerobic to anaerobic metabolism and begins breaking down lipids into ketones for energy. Rule out other etiologies for an elevated AG, but alcoholic ketoacidosis results in an elevated beta-hydroxybutyrate.



Treatment is simple, yet tricky. Break the ketogenesis cycle and shift back to aerobic metabolism. Dextrose-containing fluids, such as D5/LR, at a maintenance rate will promote insulin release. Don’t be too aggressive and address those electrolyte imbalances since these patients are high risk for refeeding syndrome.



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