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The stress of systemic disease, trauma or surgery in such predisposed patients could precipitate ketoacidosis. Our patient developed high anion gap metabolic acidosis intraoperatively due to ketosis, a potentially life-threatening complication, without any predisposing factors as a result of metabolic stress of major trauma and surgery. Aiding the interpretation, he lost 15 kg weight perioperatively, suggesting his body was in a hypercatabolic state. This report emphasises the value of anaesthetic techniques to prevent such rare complications.<\/jats:p>","DOI":"10.1136\/bcr-2022-250796","type":"journal-article","created":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T12:00:38Z","timestamp":1657108838000},"page":"e250796","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Non-diabetic euglycaemic ketoacidosis and rapid weight loss in a post-traumatic surgical patient: is the outr\u00e9 preventable?"],"prefix":"10.1136","volume":"15","author":[{"given":"Yun Xin","family":"Chin","sequence":"first","affiliation":[{"name":"Department of Anaesthesia, Intensive Care and Pain Medicine, Singapore General Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nivan","family":"Loganathan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Jurong Health Campus, National University Health System, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dinoo Suran","family":"Kirthinanda","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Jurong Health Campus, National University Health System, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,7,6]]},"reference":[{"key":"2025082707584288000_15.7.e250796.1","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.bjae.2020.04.006","article-title":"Anaesthesia, analgesia, and the surgical stress response","volume":"20","author":"Cusack","year":"2020","journal-title":"BJA Educ"},{"key":"2025082707584288000_15.7.e250796.2","doi-asserted-by":"crossref","unstructured":"Kam P , Power I . 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