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KETOMED Study Protocol: Ketonemia and emergence delirium in a multicenter study

R Poves Álvarez1, E López-Santín2, B Martínez-Rafael3

  • 1Servicio de Anestesiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; BioCritic. Group for Biomedical Research in Critical Care Medicine; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Departamento de Cirugía, Universidad de Valladolid, Valladolid, Spain; Instituto de Investigación Biosanitaria (IBioVall), Valladolid, Spain.

Revista Espanola De Anestesiologia Y Reanimacion
|May 29, 2026
PubMed

Insights

Preoperative ketonemia, a fasting-induced state, is being investigated as a potential cause of emergence delirium (ED) in children. The KETOMED study assesses if ketonemia independently predicts ED, aiming to improve paediatric anaesthetic recovery.

Area of Science:

  • Anesthesiology
  • Pediatric Medicine
  • Metabolic Research

Background:

  • Emergence delirium (ED) affects up to 33% of pediatric patients post-general anesthesia.
  • Preoperative fasting's metabolic state, specifically ketonemia, is a potential contributor to ED but remains under-investigated.
  • The KETOMED study explores ketonemia as an independent risk factor for pediatric ED.

Purpose of the Study:

  • To determine if preoperative ketonemia is independently associated with the development of emergence delirium in pediatric patients.
  • To investigate the role of ketonemia in the induction of ED.
  • To provide evidence for implementing preoperative ketonemia screening.

Main Methods:

  • A multicenter observational study involving pediatric patients undergoing general anesthesia.
  • Patients will be categorized based on the presence or absence of ED, assessed using the validated Pediatric Anesthesia Emergence Delirium (PAED) scale.
  • Key inclusion/exclusion criteria involve age, surgical type, and anesthesia protocols; primary outcome is ED's association with ketone levels.

Main Results:

  • This section is to be filled upon study completion.

Conclusions:

  • The KETOMED study addresses the under-researched role of ketone bodies in pediatric ED.
  • Findings may guide clinical practice on fasting and fluid management to reduce ED incidence.
  • The study aims to enhance the quality and safety of pediatric anesthetic recovery.
Abstract

Keywords:
Agitación al despertarAnestesia pediátricaAyuno preoperatorioCetonemiaCirugía pediátricaEmergence deliriumKetonemiaPaediatric anaesthesiaPaediatric surgeryPreoperative fasting

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