Alcoholic Ketoacidosis


Pathophysiology
  1. Starvation metabolism: free fatty acids mobilized from adipose tissue, oxidized and create acidosis
  2. Risk factors for toxicity

Diagnosis

  1. Symptoms
  2. PE
  3. Diagnostic testing

Differential Diagnosis

  1. Diabetic ketoacidosis (DKA)
  2. Isopropyl alcohol

Treatment

  1. ABCs, IV, O2, monitor
  2. IVF, carbohydrates mainstay of treatment
  3. Insulin not indicated and may cause hypoglycemia
  4. Acidosis (pH<7.1): NaHCO3 1-2 mEq/kg [1-2 mmol/L] IV
  5. Alcohol Withdrawal

Disposition

  1. Admit
  2. Drug counseling