Metabolic effects of a D-beta-hydroxybutyrate infusion in septic patients: inhibition of lipolysis and glucose production but not leucine oxidation

In this prospective randomized trial in an intensive care unit and metabolic unit, 12 sepsis patients and 6 healthy subjects took part. Septic patients received 4-hour infusions of either D-beta-hydroxybutyrate or a control solution, 12 hours after parenteral nutrition was replaced with isotonic saline. Leucine appearance and oxidation, endogenous glucose production, plasma fatty acids and glycerol were measured before and at the end of the infusion. Unlike the control, the D-beta-hydroxybutyrate infusion decreased glucose production, fatty acids and glycerol, but did not decrease leucine oxidation.