MEGX (monoethylglycinexylidide): a novel in vivo test to measure early hepatic dysfunction after hypovolemic shock.
A quantitative liver test based on the formation of the lidocaine metabolite monoethylglycinexylidide (MEGX), was used to evaluate the effect of hemorrhagic shock at 40 mmHg for 90 min on Sprague-Dawley rats. After 2 h of stabilization, lidocaine was injected (2 mg/kg). A second group received volume resuscitation with Ringer's lactate over 1 h (15 mL/kg) after shock, and after 1 h of stabilization lidocaine was administered. These groups were compared to control animals. Blood samples were drawn at 0 time (baseline), prior to lidocaine injection, and at 10, 15, 30, and 60 min after lidocaine injection. MEGX values in shocked animals were significantly lower than in the control group; in animals receiving volume resuscitation, levels were higher than the shocked animals without resuscitation, but did not reach control levels. Thus, shock produced a significant depression of hepatocyte function, which was partially reversed by Ringer's lactate resuscitation. The MEGX test appears to be a suitable tool for clinical evaluation and therapeutic intervention after shock.
Chandel
B
B
Department of Surgery, St. Louis University Health Sciences Center, Missouri 63104.
Shapiro
M J
MJ
Kurtz
M
M
Rana
W U
WU
Matthews
M
M
Jellinek
M
M
Baue
A E
AE
D000818:Animals; D001711:Biotransformation; D007511:Ischemia / Q000097:blood; D008012:Lidocaine / Q000031:analogs & derivatives* / Q000097:blood / Q000493:pharmacokinetics; D008099:Liver / Q000098:blood supply; D008111:Liver Function Tests; D008297:Male; D008862:Microsomes, Liver / Q000378:metabolism; D011237:Predictive Value of Tests; D051381:Rats; D017207:Rats, Sprague-Dawley; D012769:Shock / Q000097:blood / Q000503:physiopathology*
D008012:Lidocaine; C001173:monoethylglycinexylidide