Combined evaluation of total and functional liver plasma flows and intrahepatic shunting.
A diagnostic protocol was studied, designed to evaluate the main parameters of liver circulation in man. A water solution of D-sorbitol (S) and indocyanine green (ICG) was infused intravenously in six controls and nine cirrhotics. Steady-state renal and hepatic S clearances as well as hepatic ICG clearance were calculated. In controls the values (mean +/- SD) of the independent measurements of S and ICG hepatic clearance were 978 +/- 107 and 519 +/- 142 ml/min, respectively, while in cirrhotic patients they were 554 +/- 238 and 231 +/- 90 ml/min. Owing to the kinetic properties of S, its hepatic clearance may be regarded as a measure of functional liver plasma flow (FLPF). The total liver plasma flow (TLPF) values (mean +/- SD), calculated according to Fick's principle, were 1091 +/- 157 ml/min (S method) and 1033 +/- 153 ml/min (ICG method) in controls, and 1251 +/- 554 and 1284 +/- 677 ml/min in cirrhotics. In controls, FLPF was found to be very close to TLPF. In cirrhotic patients the difference between TLPF and FLPF (ranging from 169 to 2093 ml/min when measured by S method) was considered as an approximate estimate of intrahepatic shunting. The procedure is safe and simple and may add a new dimension to the investigation of hepatic circulation.
Molino
G
G
Dipartimento di Fisiopatologia Clinica, Università degli Studi di Torino, Turin, Italy.
Avagnina
P
P
Ballarè
M
M
Torchio
M
M
Niro
A G
AG
Aurucci
P E
PE
Grosso
M
M
Fava
C
C
D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D002406:Catheterization, Peripheral; D002985:Clinical Protocols; D005260:Female; D006503:Hepatic Veins / Q000503:physiopathology*; D006801:Humans; D007208:Indocyanine Green; D007262:Infusions, Intravenous; D008102:Liver Circulation / Q000502:physiology*; D008104:Liver Cirrhosis, Alcoholic / Q000503:physiopathology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000503:physiopathology*; D013012:Sorbitol
D013012:Sorbitol; D007208:Indocyanine Green