[一名14个月大儿童因禁食导致酮症酸中毒]

[Ketoacidosis in a 14 month old child caused by fasting].

作者信息

Eichler A, Förster H, Heller K, Behne M

机构信息

Zentrum der Anaesthesiologie und Wiederbelebung, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main.

出版信息

Anaesthesist. 1999 Nov;48(11):813-6. doi: 10.1007/s001010050790.

DOI:10.1007/s001010050790

PMID:10631441

Abstract

Preoperative starvation in order to prevent pulmonary aspiration is mandatory in elective pediatric surgery. Hypoglycemia, thirst and unwellness have been reported as undesired side effects. The metabolic response towards decreasing blood-glucose concentrations in fasting children includes gluconeogenesis and production of ketone bodies to meet the energetic demand. Accumulation of beta-hydroxybutyrate und acetoacetate in blood can lead to ketoacidosis. We report a case of a severe intraoperative ketoacidosis in a fourteen months old child complicating 36 hours of starvation.

摘要

在择期小儿手术中，为防止肺误吸而进行术前禁食是必要的。低血糖、口渴和不适已被报道为不良副作用。空腹儿童对血糖浓度降低的代谢反应包括糖异生和酮体生成，以满足能量需求。血液中β-羟基丁酸和乙酰乙酸的积累可导致酮症酸中毒。我们报告一例14个月大儿童术中发生严重酮症酸中毒的病例，该病例因禁食36小时而复杂化。