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Article
March 20, 1987

Hypokalemic Respiratory Arrest in Diabetic Ketoacidosis

Author Affiliations

From the Division of Endocrinology, Stanford University Medical Center (Drs Dorin and Crapo), and the Department of Medicine, Santa Clara Valley Medical Center (Dr Crapo), San Jose, Calif.

From the Division of Endocrinology, Stanford University Medical Center (Drs Dorin and Crapo), and the Department of Medicine, Santa Clara Valley Medical Center (Dr Crapo), San Jose, Calif.

JAMA. 1987;257(11):1517-1518. doi:10.1001/jama.1987.03390110093035
Abstract

THE OCCURRENCE of life-threatening hypokalemic hypoventilatory respiratory failure requiring intubation and respiratory support in diabetic ketoacidosis (DKA) is exceedingly rare. In none of the reported cases have serum phosphate levels been assessed within 12 hours of respiratory failure and in only one case have serial arterial blood gas measurements been performed to document hypoventilation.1 The recent documentation of severe hypophosphatemia as a cause of hypoventilation and the fact that decrements in serum phosphate and serum potassium levels frequently parallel one another in DKA call into question the importance of hypokalemia to the respiratory response in DKA.

We report a case of DKA in a young, otherwise healthy man whose treatment was complicated by severe hypokalemia and a hypoventilatory respiratory arrest without severe hypophosphatemia. We further discuss issues relating to the assessment and treatment of the hypokalemic patient with DKA at risk for ventilatory failure.

Report of a Case 

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