Published online Jul 25, 2015. doi: 10.4239/wjd.v6.i8.1009
Peer-review started: August 27, 2014
First decision: December 17, 2014
Revised: January 8, 2015
Accepted: May 26, 2015
Article in press: May 27, 2015
Published online: July 25, 2015
Processing time: 343 Days and 0.7 Hours
Respiratory failure complicating the course of diabetic ketoacidosis (DKA) is a source of increased morbidity and mortality. Detection of respiratory failure in DKA requires focused clinical monitoring, careful interpretation of arterial blood gases, and investigation for conditions that can affect adversely the respiration. Conditions that compromise respiratory function caused by DKA can be detected at presentation but are usually more prevalent during treatment. These conditions include deficits of potassium, magnesium and phosphate and hydrostatic or non-hydrostatic pulmonary edema. Conditions not caused by DKA that can worsen respiratory function under the added stress of DKA include infections of the respiratory system, pre-existing respiratory or neuromuscular disease and miscellaneous other conditions. Prompt recognition and management of the conditions that can lead to respiratory failure in DKA may prevent respiratory failure and improve mortality from DKA.
Core tip: Despite progress in its management, diabetic ketoacidosis (DKA) continues to cause significant morbidity and mortality. One of the conditions aggravating the course of DKA and causing several deaths is respiratory failure, which can be detected at presentation or, more frequently during the course of treatment of DKA. Several risk factors for respiratory failure in DKA are preventable. Early recognition and management of these risk factors, as well as early recognition of respiratory failure have the potential to improve both morbidity and mortality resulting from DKA.