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Korean Journal of Anesthesiology 1994;27(5):421-427.
DOI: https://doi.org/10.4097/kjae.1994.27.5.421   
The Changes of Arterial Ketone Body Ratio and Osmolal Gap during Hemorrhagic Shock in Rabbit.
Ill Hwan Kim, Keung Woo Lee, Young Kyun Choi, Young Jae Kim, Jin Yoo Park, Chee Mahn Shin, Ju Yuel Park
Department of Anesthesiology, Inje University College of Medicine, Pusan, Korea.
Abstract
The ratio of acetoacetate to 8-hydroxybutyrate (ketone body ratio) in the blood may reflects the mitochondrial free NAD+/NADH ratio in the liver. Also arterial ketone body ratio will reflects the energy status of the hepatocytes, because mitochondrial free NAD+/NADH ratio is closely related to oxidative phosphorylation. Arterial ketone body ratio and osmolal gap, the difference between measured osmolality and calculated osmolality, were measured 30 min after the induction of hemorrhagic shock with mean arterial blood pressure at 40 mmHg in ten rabbits. Arterial ketone body ratios decreased significantly (p<0.05) from 0.74+/-0.17 to 0.38+/-0.09 and osmolal gap increased significantly (p<0.05) from 17.7+/-5.9 mOsm/Kg to 32.8+/-12.3 mOsm/Kg at 30 min after the induction of hemorrhagic shock. These results suggest that in hemorrhagic shock, decreased arterial ketone body ratio which reflects the inhibition of the TCA cycle is associated with increase of osmolal gap.
Key Words: Hemorrhagic shock; Ketone body ratio; Osmolal gap


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