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Ketoacidosis

 2021

Hana Harazim, MD, PhD, Pavlína Přikrylová, Michal Reška

Ketoacidosis is an acute, life-threatening condition, which is caused by the presence of ketone bodies in the blood. The treatment has its specifics as well as drawbacks, the knowledge of which is essential for successful therapy. This algorithm is focusing on diabetic ketoacidosis, which occurs mostly in patients with type I diabetes; however, alcoholic ketoacidosis also exists, albeit being less common and having less acute progress. The algorithm introduces typical signs, carries through the therapy with a focus on addressing some of the common setbacks, and provides ways of preventing future similar conditions.

iconInteractive algorithm
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Short test
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Jiří Chvojka, MD, PhD Intensive Care Unit Physician, 1st Internal Medicine Department, University Hospital Plzeň, Plzeň, Czech Republic

Diabetic ketoacidosis (DKA) is one of the most common complications of diabetes mellitus and one of the most common reasons for acute emergency admission in diabetics. If left untreated, it has a high mortality rate. On the contrary, properly treated has an excellent prognosis. The presented algorithm clearly allows to understand not only the pathophysiology of DKA, but above all it summarizes the basic steps in treatment. It emphasizes the possible pitfalls of electrolyte imbalances and the importance of their timely and adequate solution.

FARKAS, Josh. Anatomy of a DKA resuscitation. The Internet Book of Critical Care [online]. Vermont: Farkas, 2016 [acc. 2021-6-16]. Availible at: https://emcrit.org/ibcc/dka/

FARKAS, Josh. Diagnosis of metabolic acid-base disorders. The Internet Book of Critical Care [online]. Vermont: Farkas, 2019 [acc. 2021-6-16]. Availible at: https://emcrit.org/ibcc/ph/

ARONSON, Peter S. a Gerhard GIEBISCH. Effects of pH on Potassium: New Explanations for Old Observations. Journal of the American Society of Nephrology [online]. 2011, 22(11), 1981-1989 [acc. 2021-6-17]. ISSN 1046-6673. Availible at: doi:10.1681/ASN.2011040414

SHIRANI, Farhad, Reza SALEHI, Afsoon E. NAINI, Reza AZIZKHANI a Ali GHOLAMREZAEI. The effects of hypotension on differences between the results of simultaneous venous and arterial blood gas analysis. Journal of Research in Medical Sciences [online]. 2011, 16(2), 188-194 [acc. 2021-6-17]. ISSN 1735-7136. Availible at: http://jrms.mui.ac.ir/index.php/jrms/article/view/6587/2562

MARINO, Paul L. The ICU Book. 3rd ed. Baltimore: Williams and Wilkins, 2007. ISBN 978-0781748025

ŠEVČÍK, Pavel a Martin MATĚJOVIČ, ed. Intenzivní medicína. 3., přeprac. a rozš. vyd. Praha: Galén, c2014. ISBN 9788074920660

MALÁSKA, Jan, Jan STAŠEK, Milan KRATOCHVÍL a Václav ZVONÍČEK. Intenzivní medicína v praxi. Praha: Maxdorf, [2020]. Jessenius. ISBN 978-80-7345-675-7

Keywords: inzuline, diabetes mellitus, hyperkalemia, acidosis, ketone bodies

inserted: 9. 8. 2021 | last modified on: 5. 1. 2022

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