Respiratory Failure in the Course of Treatment of Diabetic Ketoacidosis.

PRESENTATION Three patients developed acute respiratory failure during treatment of diabetic ketoacidosis (DKA) diagnosed by the combination of hyperglycemia, anion gap metabolic acidosis, and presence of ketone bodies in serum. All three required tracheal intubation and mechanical ventilation. Table 1 shows pertinent laboratory values at admission and immediately before tracheal intubation. Serum anion gap was computed as [Na]S – ([Cl]S + [TCO2]S), where [Na]S, [Cl]S, and [TCO2]S are, respectively, the serum sodium, chloride, and total carbon dioxide concentrations. Serum tonicity in mOsm/l was calculated as 2 × [Na]S + [Glu]S, where [Glu]S is serum glucose concentration in mmol/l.