RT Book, Section
A1 Patel, Krunal
A1 Kohli-Seth, Roopa
A2 Atchabahian, Arthur
A2 Gupta, Ruchir
SR Print(0)
ID 57263750
T1 Chapter 210. Diabetic Ketoacidosis
T2 The Anesthesia Guide
YR 2013
FD 2013
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-176049-2
LK accessanesthesiology.mhmedical.com/content.aspx?aid=57263750
RD 2024/04/16
AB DKA  is  defined  by  a  lack  of  insulin  or  an  excess  of  hyperglycemic  hormones  leading  to  an  inability  by  the  tissues  to  use  glucose.  This  leads  to  lipolysis  and  the  synthesis  of  ketoacids  that  will  be  used  as  fuel.  Ketoacids  will  trigger  metabolic  acidosis  and  polyuria  leading  to  severe  dehydrationTriggering  factors:  Inaugural  in  DM1  (common,  revealing  about  10%  of  DM1)  or  DM2  (rare)Noncompliance  or  iatrogenic  (inadequate  insulin  coverage,  steroids,  beta-agonists)Infection  or  inflammation  (e.g.,  pneumonia,  UTI,  foot  ulcer,  abdominal  [appendicitis,  cholecystitis,  pancreatitis,  etc.])MIPregnancyTraumaMortality  in  DKA  is  primarily  due  to  the  underlying  precipitating  illness  and  only  rarely  due  to  the  metabolic  complications  of  hyperglycemia  or  ketoacidosis.  The  prognosis  of  DKA  is  substantially  worse  at  the  extremes  of  age  and  in  the  presence  of  coma  and  hypotensionDKA  can  present  as  severe,  pseudosurgical  abdominal  pain.  Accurate  diagnosis  will  prevent  unnecessary  surgery