Respiratory

Minute volume is always increased in patients with diabetic ketoacidosis unless they are unconscious. This is a compensatory ventilatory response to the acidosis. Ketoacids are produced as a direct result of the lack of insulin and lactate due to generalized ischemia. The gas exchange needs to be assessed with arterial blood gases and underlying respiratory pathology excluded.

A chest radiograph may show hyperinflated lung fields consistent with hyperventilation. It may also point to precipitating illness, such as congestive cardiac failure or a pneumonia.

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