Influence of Abdominal Surgical Trauma on Substrate Utilization by the Human Brain

In 10 patients undergoing cholecystectomy, measurements of jugular venous blood flow (one side) and arterio‐jugular vein differences of oxygen, glucose, lactate, pyruvate, glycerol, 3‐hydroxybutyrate and alanine were made. The arterial concentration of 3‐hydroxybutyrate was raised during surgery, but this substrate only covered a minute part of the total energy demand. The need for substrates of oxidative metabolism in the brain was met by glucose. During the operation the stoichiometrically calculated oxygen uptake was lower than that of glucose, indicating an increase in the brain glucose content.