Blood Acetone Concentration Associated With Toxicity
A specific “toxic” blood acetone concentration is not defined for all clinical scenarios. Toxicity is dose-related and depends on the exposure route, timing of sampling, and co-ingestants.
Common Reference Ranges in Humans
Endogenous (background) blood acetone concentrations have been reported up to about 10 µg/mL. [1] DKA-associated acetone concentrations have been reported in a range of 100 to 700 µg/mL (100–700 mg/L). [1]
Estimated Toxic and Lethal Concentrations
Toxic range of blood acetone has been estimated at 200 to 300 µg/mL (200–300 mg/L). [1] Lethal concentrations have been estimated at greater than 550 µg/mL (>550 mg/L). [1] Intoxication has not been observed in volunteers with blood acetone concentrations up to 33 µg/mL. [1]
Clinical Interpretation Based on Context
High blood acetone concentrations can occur without classic “acetone intoxication” patterns when ketoacidosis is present. [1] Acute acetone toxicity in humans primarily involves CNS depression that can progress to stupor, coma, and respiratory depression at high doses. [1]
Practical Clinical Threshold Use
A blood acetone concentration in the 200–300 µg/mL range is consistent with historically estimated toxicity thresholds. [1] A blood acetone concentration >550 µg/mL is consistent with historically estimated lethal-range concentrations. [1]
Urgent Safety Considerations
Any suspected acetone poisoning with altered mental status, respiratory compromise, seizures, or severe metabolic acidosis requires emergency evaluation irrespective of measured acetone concentration. [1]