Ketoacidosis in a 14 month old child caused by starvation

Preoperative starvation in order to prevent pulmonary aspiration is mandato ry in elective pediatric surgery. Hypoglycemia, thirst and unwellness have been reported as undesired side effects. The metabolic response towards dec reasing blood-glucose concentrations in fasting children includes gluconeog enesis and production of ketone bodys to meet the energetic demand. Accumul ation of beta-hydroxybutyrate und acetoacetate in blood can lead to ketoaci dosis. We report a case of a severe intraoperative ketoacidosis in a fourte en months old child complicating 36 hours of starvation.