Acute cardiac care & resuscitationRandomised controlled trial
Beneficial Effects of Ketone Ester in Patients With Cardiogenic Shock
- Randomised crossover trial
- double-blind
- placebo-controlled
Authors' conclusion
Treatment with KE improved cardiac output, biventricular function, tissue oxygenation, and glycemic control in patients with CS
Study context
- Population
- Patients with cardiogenic shockcrossover
- Participants
- 12 patients
- Comparison
- Ketone ester vs placebo
- Primary endpoint
- Hemodynamic effects (cardiac output)
- Follow-up
- 3 hours after each intervention
Primary result
As reported in the abstract
Cardiac output (AUC of relative change)
P = 0.044
Further findings
Circulating 3-hydroxybutyrate
P < 0.001
| Outcome | increase (W) (95% CI) | P value | |
|---|---|---|---|
| Cardiac power output, mixed venous saturation, forearm perfusion · cardiac power output | 0.07 (0.01–0.14) | P = 0.037 | |
| −0.100.10.2Difference, W (linear scale) |
| Outcome | increase (percentage points) (95% CI) | P value | |
|---|---|---|---|
| Cardiac power output, mixed venous saturation, forearm perfusion · mixed venous saturation | 3 (1–5) | P = 0.010 | |
| Cardiac power output, mixed venous saturation, forearm perfusion · forearm perfusion | 3 (0–6) | P = 0.026 | |
| −50510Difference, percentage points (linear scale) |
Ventricular filling pressures, HR, mean arterial and pulmonary arterial pressures
- Right ventricular filling pressure reduced
- P = 0.048
- Left ventricular filling pressure reduced
- P = 0.017
- HR and mean arterial and pulmonary arterial pressures remained similar
LVEF, glucose, insulin
- LVEF improved
- 4 percentage points (95% CI: 2-6 percentage points; P = 0.005)
- Glucose decreased
- 2.6 mmol/L (95% CI: −5.2 to 0.0; P = 0.047)
- Insulin levels remained unaltered
Original publication
Beneficial Effects of Ketone Ester in Patients With Cardiogenic Shock. JACC Heart Fail. Published 12 July 2023. doi:10.1016/j.jchf.2023.05.029
Summarised from the published abstract; every number is checked against it