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 mumol/liter, the burn patients responded with an average level of 385 +/- 77 mumol/liter (p less than 0.01).