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Colombian Journal of Anestesiology
versión impresa ISSN 0120-3347versión On-line ISSN 2256-2087
Resumen
TRUJILLO, Alexander; RAMIREZ, Alejandro y ARANGO, Fernando. Difference in ketone bodies levels between diurnal and nocturnal fasting in children: observational study. Rev. colomb. anestesiol. [online]. 2023, vol.51, n.3, 40. Epub 01-Sep-2023. ISSN 0120-3347. https://doi.org/10.5554/22562087.e1064.
Introduction
Children are susceptible to developing preoperative ketonemia, which can be affected by changes in the circadian rhythm and counter-regulatory hormones. It is unclear whether ketonemia depends on the timing of fasting.
Objective
To assess the effect of preoperative fasting time (diurnal vs. night) on the preoperative concentration of ketone bodies in children.
Methods
We conducted a prospective-observational clinical study between September 2020 and March 2021, including children under 48 months of age scheduled for elective surgery. Two groups were identified based on fasting time, as follows: diurnal fasting (group A, n = 40) and nocturnal fasting (group B, n = 52). Demographic data, duration of fasting, time of excess fasting, type of food intake, the concentration of ketone bodies and capillary blood glucose, level of anxiety, and dehydration were analyzed in both groups.
Results
Diurnal fasting was associated with higher incidence of ketonemia compared with nocturnal fasting (Group A: 62.5% (95% CI 48.1-82.0); group B: 38,5% (95% CI 26.5-52.5), P=0.02). Most of the patients exceeded the duration of fasting recommended by preoperative fasting guidelines (95.6%). The type of food eaten before surgery was significantly associated with the presence of ketonemia (P=0.01).
Conclusions
Preoperative ketonemia is relatively common in patients under 48 months of age, especially among those who undergo diurnal fasting compared to nocturnal fasting.
Palabras clave : Children; Anesthesia; Ketonemia; Fasting; Circadian clock; Anesthesiology.