Alternative Cerebral Fuels in the First 5 Days in Healthy Te
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A Study was conducted in 67 infants to determine plasma lactate and beta-hydroxybutyrate concentrations of healthy infants in the first 5 days and their relationships with glucose concentrations.

Results:
In 67 infants, plasma lactate concentrations were higher in the first 12 h, decreasing to 12 after 48 h.
Plasma beta-hydroxybutyrate concentrations were low in the first 12 h (1.9), peaked at 48 -72 h (7.3), and fell by 96 h (0.9).
--Compared with infants with plasma glucose concentrations above the median (67 mg/dL) those with lower glucose had lower lactate concentrations in the first 12 h and higher beta-hydroxybutyrate concentrations between 24-96 h.
--Lower interstitial glucose concentrations were also associated with higher plasma beta-hydroxybutyrate concentrations but only if the lower glucose lasted more than 12 h.
--Glucose contributed 72 to 84% of estimated potential ATP throughout the 5 days, with lactate contributing 25% on day 1 and beta-hydroxybutyrate 7% on days 2 to 3.

Conclusively, Lactate on day 1 and beta-hydroxybutyrate on days 2 to 4 may contribute to cerebral fuels in healthy infants, but are unlikely to provide neuroprotection during early or acute hypoglycemia.

Source: https://www.jpeds.com/article/S0022-3476(20)31573-0/fulltext?rss=yes
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