Point-of-care measurements of blood ketones in newborns. Issue 5 (1st September 2019)

• Record Type: Journal Article
• Authors: Harris, Deborah L; Weston, Philip J; Harding, Jane E
• Is Part Of: Archives of disease in childhood. Volume 104:Issue 5(2019)
• Page Start: F544
• Publication Date: 2019-09-01
• Subjects: beta-hydroxybutyrate -- hypoglycaemia -- infant feeding; Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/archdischild-2018-316293
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : Objective: Babies may use alternative cerebral fuels including ketones when blood glucose concentrations are low, but laboratory ketone measurements are slow and expensive. Point-of-care measurement of ketone concentrations, if sufficiently accurate, may provide useful information for clinical care. Patients and design: Eligible babies were 35–42 weeks' gestation, ≤10 days old and admitted to the newborn intensive care unit. At the time of clinically indicated blood tests, additional samples were taken to measure beta-hydroxybutyrate using a point-of-care analyser and the laboratory method. Results: One-hundred and fifty babies had 142 paired samples. Overall point-of-care accuracy was excellent (mean difference 0.00 mmol/L) and precision was moderate (SD 0.18 mmol/L). A point-of-care measurement ≥0.4 mmol/L was highly predictive of a laboratory measurement ≥0.4 mmol/L (area under the curve 0.98). Conclusion: Point-of-care measurement of blood beta-hydroxybutyrate concentrations is sufficiently accurate in newborns to be potentially useful in clinical care. Clinical trial registration number: Registered with the Australian and New Zealand Clinical Trials Registry ACTRN: 12616000784415. The study was registered before recruitment commenced.