The Effect of Major Thermal Injury on Plasma Ketone Body Levels

Eleven patients with more than 30% total body surface burns were studied during 3 days of starvation and three more days of unrestricted feeding following their injury. All patients developed marked protein mobilization as demonstrated by 3rd day urine nitrogen excretion of 17.1 g daily compared to control excretion of 11.8 g N daily. As a group, the patients failed to mount the expected ketonemic response during their initial period of starvation. Whereas normal fasted controls achieved plasma ketone body levels of 727 ± 81 μmol/ liter, the burn patients responded with an average level of 385 ± 77 μmol/liter (p < 0.01). (Journal of Parenteral and Enteral Nutrition 9 :153–158, 1985)