Changes in Ketone Bodies in Pediatric Surgical Patients : 2. Findings on the Patients with Major Operation and Minor Operation

Abstract

Blood ketone body levels and plasma free fatty acid levels during 7 post operative days were measured in 25 patients with minor operation and 62 patients with major operation. The results were as follows: 1. Blood ketone body levels elevated after operation, and the values after major operation were significantly higher and remained high in longer periods than the values after minor operation. 2. Acetoacetic acid, 3-hydroxybutyric acid and total ketone body of the patients with higher caloric intake (more than 50 Cal/Kg/day) were significantly lower than those of the patients with low caloric intake (under 50 Cal/Kg/day) during early post operative days. 3. Ketone bodies levels of the patients with congenital biliary atresia were lower than those of the other patients with major operation. Moreover, free fatty acid/ketone body ratio of the former was greater than that of the latter after operation These suggest that the patients with congenital biliary atresia have limited ability of ketogenesis after operation. 4. Plasma free fatty acid levels were also elevated by surgical insult, and there was a significant correlation between blood ketone body and plasma free fatty acid during post operative days.