• M Beylot, D Chassard, C Chambrier, M Guiraud, M Odeon, B Beaufrère, and P Bouletreau.
• INSERM U 197, Faculté de Médecine Alexis Carrel, Lyon, France.
• Crit. Care Med. 1994 Jul 1; 22 (7): 1091-8.

ObjectiveTo study the effect of a D-beta-hydroxybutyrate infusion on protein metabolism, lipolysis, and endogenous glucose production in septic patients.DesignProspective, randomized trial.SettingIntensive care unit (ICU) and metabolic unit at a university hospital.PatientsTwelve ICU patients with sepsis and six healthy normal subjects.InterventionsSeptic patients were administered 4-hr infusions of either D-beta-hydroxybutyrate or a control solution, 12 hrs after parenteral nutrition was replaced with an isotonic saline infusion.Measurements And Main ResultsThe appearance and oxidation rates of leucine (L[1-13C]leucine) and endogenous glucose production (D[6,6-2H2]glucose), plasma fatty acids, and glycerol values were measured before and at the end of infusion of D-beta-hydroxybutyrate or control solution. Unlike the control test, the D-beta-hydroxybutyrate infusion decreased glucose production, fatty acids, and glycerol concentrations, but failed to decrease the leucine oxidation rate.ConclusionExogenous ketone-bodies infusion decreased lipolysis and glucose production in septic patients but had no beneficial effect on protein metabolism, as evaluated with L[1-13C]leucine.

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