Ketones are substances produced in the liver when fat cells break down in the blood. A serum ketone test is a measurement of how many ketones are in the blood.

Acetone bodies; Ketones - serum; Nitroprusside test; Ketone bodies - serum; Ketones - blood

Blood is most often drawn from a vein. The vein usually used is on the inside of the elbow or the back of the hand.

Theprocedure is done in the following way:

• The site is cleaned with germ-killing medicine (antiseptic).
• The health care provider wraps an elastic band around the upper arm to apply pressureto the area and make the vein swell with blood.
• The health care provider gently inserts a needle into the vein.
• The blood collects into an airtight vial or tube attached to the needle.
• The elastic band is removed from your arm.
• The needle is removed.
• The puncture site is covered to stop any bleeding.

In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. Afterward, a bandage may be placed over the area if there is any bleeding.

No preparation is needed.

When the needle is inserted to draw blood, you may feel slight pain or only a prick or stinging. Afterward, there may be some throbbing.

This test is used to diagnose ketoacidosis.

A normal test result would be negative, meaning there are no ketones in the blood.

Normal value ranges may vary slightly among different laboratories. Talk to your health care provider about the meaning of your specific test results.

A test result is positive if ketones are found in the blood. This may indicate:

• Alcoholic ketoacidosis
• Diabetic ketoacidosis
• Starvation
• Uncontrolled blood glucose in diabetics

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Drawing blood from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

• Excessive bleeding
• Fainting or feeling light-headed
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

A diet low in carbohydrates can increase ketones.

Khan MI, Weinstock RS. Carbohydrates. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 16.

Seifter JL. Acid-base disorders. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 120.