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ROBERT ELMAN, M.D.; T. E. WEICHSELBAUM, Ph.D.; Marjorie A. Graul, R.N.
AMA Arch Surg. 1951;62(5):683-697. doi:10.1001/archsurg.1951.01250030693010.
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EVEN though glycosuria and acetonuria are fairly common after operation, their exact significance is not generally known. Do they mean a serious disturbance in carbohydrate metabolism? Is the excretion of ketone bodies evidence of a transient overproduction thereof by the liver or of diminished utilization by peripheral tissue? Is the glycosuria the result of a diminution of peripheral utilization of glucose or of increased glycogenolysis? A number of surgical patients were observed in whom quantitative determinations of the 24 hour output of glucose and of acetone were made in an attempt to answer these questions. A few of these observations were briefly reported in a previous paper from this laboratory.1

PREVIOUS WORK  In an exhaustive report published in 1933, Roscher2 studied and reviewed postoperative acidosis and ketonuria. A disturbance in acid-base balance was common, particularly in patients operated on under general anesthesia. A fall in the pH and


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