{
  "abstract": "The potential contribution of ketones and lactate as alternative fuels for ATP production during transition after birth in term infants is well recognised, but data from preterm infants are more limited. Gordon Xin Hua Liu and colleagues measured both metabolites serially over the first week of life in 168 very low birth weight preterm infants<34 weeks gestation who were enrolled in the REACT study of continuous glucose monitoring. There were more than 2000 measurements of each metabolite. They found that neither metabolite contributed substantially as energy sources at this time. B-OH butyrate levels were low throughout and represented around 1% of ATP contribution. Lactate levels represented 8–9% during days 1–2, falling to 4%–5% by days 7–8. There was no relationship between simultaneous blood glucose concentrations, increasing macronutrient support or receipt of insulin with ketone or lactate concentrations. Their finding that that preterm infants must rely predominantly on glucose as their primary energy source is consistent with prior observations that preterm infants may be at increased risk of hypoglycaemic injury. See page F196",
  "authors": [
    {
      "affiliations": [
        "Consultant Neonatologist, Simpson Centre for Reproductive Health, Edinburgh, Edinburgh, UK"
      ],
      "name": "Ben J Stenson"
    }
  ],
  "title": "Fantoms",
  "uid": "7a83fec5-e25c-5cd4-a701-584967a15d1c"
}