POC Betahydroxybutyrate

I attended a presentation by Dr Dennis Begos, the Senior Medical Director at Nova, and learned a lot about this topic. Thought I'd share some info on BHB. Thankful for the annual meetings our Northwest Point of Care Group puts on; there are always lots of great speakers that increase my knowledge of our field.

I knew we were getting tons of negatives on our ER DKA patients and in years past have fielded several calls from ER docs asking if our test detected BHB, which it does not. (okay, maybe not TONS, but enough to catch my attention and do some basic research years ago)

Turns out, in the UK >75% of hospitals use POCT BHB. It's a shame we haven't caught on in the US yet. I want to pursue this for our facility, but it will require education. Studies have shown decreased time to resolution of DKA monitoring BHB vs Acetoacetate. Almost 12 hours faster treatment times. Patients with euglycemic DKA (becoming more common with increased numbers of patients on SGLT-2 inhibitors) especially require monitoring with BHB; our standard ketone won't detect BHB and will often give a negative, but the patient's BHB will be elevated. BHB comprises up to 80% of the ketones produced by our bodies. 

And thank you, Kathleen!!! I'm going to be researching that kit. This had fallen back a ways on my to-do list and is moving back up thanks to this new lead on a waived device.