Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/20502
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dc.contributor.authorMillar, Robert-
dc.contributor.authorHarding, Anton-
dc.date2019-03-27-
dc.date.accessioned2019-04-02T01:07:32Z-
dc.date.available2019-04-02T01:07:32Z-
dc.date.issued2019-03-27-
dc.identifier.citationEmergency Medicine Australasia : EMA 2019; 31(3): 314-320-
dc.identifier.urihttp://ahro.austin.org.au/austinjspui/handle/1/20502-
dc.description.abstractAcute ketosis is an important physiological mechanism to prevent irreversible neurological damage from hypoglycaemia during starvation, and represents a significant metabolic stress. A cohort of children adapt to relatively short periods of reduced caloric intake by generating large quantities of ketone bodies. When excessive, the gastrointestinal symptoms of starvation ketosis such as nausea and pain may create a vicious cycle that delays spontaneous resolution. The presence of ketones can be dismissed as a normal feature of childhood metabolism, sometimes even when extreme. A broader understanding of this process under the banner of 'accelerated starvation of childhood' is helpful for clinicians managing acute illness in children. We advocate that children less than 7 years of age with a history suggestive of accelerated starvation of childhood should be screened by emergency clinicians for ketosis using a simple and cheap bedside capillary test, even if glucose levels are greater than 2.6 mmol/L. Identification and appropriate management of ketosis may alleviate the distressing gastrointestinal symptoms associated with many minor illnesses, and potentially prevent hypoglycaemia in some children. Appropriate advice to carers may be helpful to prevent further episodes. Illustrative case examples from our own practice are provided.-
dc.language.isoeng-
dc.subjectchild-
dc.subjectglucose-
dc.subjectketone-
dc.subjectketosis-
dc.subjectstarvation-
dc.titleReview article: Accelerated starvation of childhood: Have I judged ketones?-
dc.typeJournal Article-
dc.identifier.journaltitleEmergency Medicine Australasia : EMA-
dc.identifier.affiliationAustin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationThe University of Melbourne, Melbourne, Victoria, Australiaen
dc.identifier.affiliationEpworth Hospital, Melbourne, Victoria, Australiaen
dc.identifier.affiliationRoyal Children's Hospital, Melbourne, Victoria, Australiaen
dc.identifier.doi10.1111/1742-6723.13276-
dc.identifier.orcid0000-0002-1854-9478-
dc.identifier.pubmedid30916481-
dc.type.austinJournal Article-
dc.type.austinReview-
item.grantfulltextnone-
item.languageiso639-1en-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
item.cerifentitytypePublications-
crisitem.author.deptEmergency-
crisitem.author.deptPaediatrics-
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