Serial changes in plasma ketone concentrations in patients with acute brain injury

White, Hayden, Venkatesh, Balasubramanian, Jones, Mark and Fuentes, Hesly (2016) Serial changes in plasma ketone concentrations in patients with acute brain injury. Neurological Research, 39 1: 1-6. doi:10.1080/01616412.2016.1251695

Author White, Hayden
Venkatesh, Balasubramanian
Jones, Mark
Fuentes, Hesly
Title Serial changes in plasma ketone concentrations in patients with acute brain injury
Journal name Neurological Research   Check publisher's open access policy
ISSN 1743-1328
Publication date 2016-10-27
Sub-type Article (original research)
DOI 10.1080/01616412.2016.1251695
Open Access Status Not yet assessed
Volume 39
Issue 1
Start page 1
End page 6
Total pages 6
Place of publication Abingdon, Oxfordshire, United Kingdom
Publisher Taylor & Francis
Language eng
Formatted abstract
Objective: Acute brain injury (ABI) is a catastrophic event, leading to disruption of the normal cerebral metabolic pathways and a subsequent cerebral energy deficit. Ketones (beta-hydroxybutyrate (BHB) and acetoacetate) may represent an alternative metabolic substrate with the potential to improve cerebral energy supply and decrease injury. The purpose of this study was to evaluate baseline ketone concentrations in the ABI population.

Methods: Thirty-eight patients with ABI were enrolled into the study and followed for up to 7 days. We collected arterial blood samples immediately after admission and daily to measure the levels of BHB and acetoacetate. Where possible, matching cerebrospinal fluid (CSF) specimens were also collected.

Results: During the study period, plasma BHB levels were increased initially but normalized by day 3 while acetoacetate levels remained within the normal range. The change in BHB was significant. There were 30 observations in 10 patients where BHB could be measured in both blood and CSF. When the data were averaged over patients there was a weak correlation between blood and CSF BHB (Spearman’s ρ = 0.62, p = 0.054).

Conclusion: Blood ketone concentrations remain low within the ABI population. An external source of ketones will be required to increase blood concentrations to clinically relevant levels.
Keyword Acute brain injury
Subarachnoid haemorrhage
Traumatic brain injury
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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