title: The effects of topical hypothermia and steroids on ATP levels in an in vivo liver ischemia model.
abstract: Complex hepatic surgery often requires occlusion of the portal triad in order to decrease parenchymal bleeding. This study was undertaken to evaluate the effects of topical hypothermia and intravenous steroids on liver ischemia by measuring adenosine triphosphate (ATP) levels within the hepatic parenchyma. Forty New Zealand white rabbits were divided into four experimental and four control groups. All experimental animals underwent laparotomy and ligation of the porta hepatis. Serial liver biopsy specimens were obtained at predetermined time intervals. Group I received no further intervention. Group II were topically cooled until intrahepatic temperature reached 30 degrees C. Group III received preligation intravenous methylprednisolone (30 mg/kg). Group IV received both steroids and topical hypothermia. The corresponding control groups underwent laparotomy and isolation of the porta without ligation. Adenosine triphosphate was extracted from the liver parenchyma and quantified by high-performance liquid chromatography (HPLC). The data were analyzed using a three-factor mixed analysis of variance (ANOVA). There was a statistically significant protective effect on ATP levels provided by topical hypothermia at 15 and 30 minutes of ischemia (p < 0.01), but not at 60 minutes (p > 0.05). Steroids were not found to have any protective effect on ATP levels at any time point. The combination of steroids and topical hypothermia provided significant preservation of hepatic parenchymal ATP levels, although less than that of hypothermia alone, at 15 and 30 minutes of ischemia (p < 0.01).
authors.affiliation: Shock/Trauma Unit, Bellevue Hospital Center, New York, NY 10016.
authors.forename: Y
authors.initials: Y
authors.lastname: Eidelman
authors.forename: P M
authors.initials: PM
authors.lastname: Glat
authors.forename: H L
authors.initials: HL
authors.lastname: Pachter
authors.forename: R
authors.initials: R
authors.lastname: Cabrera
authors.forename: C
authors.initials: C
authors.lastname: Rosenberg
mesh_terms: D000255:Adenosine Triphosphate / Q000378:metabolism*; D000704:Analysis of Variance; D000818:Animals; D002851:Chromatography, High Pressure Liquid; D004195:Disease Models, Animal; D007036:Hypothermia, Induced / Q000379:methods; D007262:Infusions, Intravenous; D007511:Ischemia / Q000378:metabolism*; D008099:Liver / Q000098:blood supply* / Q000187:drug effects / Q000378:metabolism*; D008775:Methylprednisolone / Q000008:administration & dosage / Q000494:pharmacology*; D011817:Rabbits
chemical_list: D000255:Adenosine Triphosphate; D008775:Methylprednisolone