Ketones/ketoacids/hydroxy acids, in particular, beta-hydroxybutyrate, induce nausea and vomiting that consequently aggravate fluid and electrolyte loss already existing in DKA. Moreover, acetone produces the fruity breath odor that is characteristic of ketotic patients. ...
anion gap), and serum ketones, preferably beta-hydroxybutyrate. Utilizing urine ketones can be challenging, as this test mainly assesses the presence of acetoacetate, which may not be necessarily present.[5,6,10]Beta-hydroxybutyrate is the predominant ketone in DKA, which is converted to acetoaceta...
Lab workup revealed leukocytosis, severe hyperglycemia, and severe anion gap metabolic acidosis with beta hydroxybutyrate level of 14.20 mmol/L (normal: 0.02-0.27 mmol/L). He was diagnosed with DKA and started on intravenous fluids, and insulin as per institutional DKA protocol. Approximately 12 ...
Serum or capillary beta-hydroxybutyrate levels ABG measurements Complete blood count (CBC) BUN and creatinine levels Urine and blood cultures if intercurrent infection is suspected Electrocardiogram (ECG; or telemetry in patients with comorbidities) Note that high serum glucose levels may lead ...
Three days prior to admission, she had been experiencing shortness of breath and was started on prednisone for a presumed COPD exacerbation. On presentation, her anion gap was measured to be 31 with a serum bicarbonate level of <5 mmol/L. Beta hydroxybutyrate was critically elevated 118mg/dl...
and HCO3 17 mmol/L Arterial blood gas revealed pH 7 14 with normal lactate level A beta-hydroxybutyrate (BHB) level was 2 9 mmol/L, but Propofol Infusion Syndrome (PRIS) was considered as etiology of the anion gap acidosis given high propofol requirements Propofol was stopped and bicarbonate...
Beta-Hydroxybutyrate level was 6.3(0.0 -0.27 mmol/L). UA was only significant for glucose level of >1000(negative) and ketone level of 40(negative). Lipase level was 539(73-393 U/L). CT abdomen ruled out acute pancreatitis. No infection source was identified. Upon admission to the ICU ...
During her treatment of sepsis she was diagnosed with euglycemic DKA (A1c - 10.3, Blood glucose 240-180s, anion gap metabolic acidosis, glucosuria >1000, Ketone bodies of 40, beta hydroxybutyrate 3.18, serum osmolality 303, urine osmolality 140, urine output 13 liters/24 hrs). Furthermore ...