title: Energy metabolism in acute hepatic failure.
abstract: BACKGROUND
  Conflicting data are available concerning energy metabolism in liver disease. Changes should be most pronounced in acute hepatic failure in which loss of 85% of liver cell mass is reported. Metabolic rate could be decreased due to impairment in liver mass but may also be increased as a result of systemic-mediator actions. To clarify this issue we studied energy metabolism in acute hepatic failure.
  
  
  METHODS
  Energy metabolism was evaluated by indirect calorimetry in 12 patients with acute liver failure and 22 sex-, age-, and body size-matched healthy individuals. In controls and 5 patients, studies were performed in the postabsorptive state; the remaining 7 patients received glucose at a rate of 8 mumol/kg body weight.min to prevent hypoglycemia.
  
  
  RESULTS
  Resting energy expenditure was increased in acute liver failure compared with healthy controls (5.1 +/- 0.14 kJ.min-1 x 1.73 m-2 vs. 3.97 +/- 0.08 kJ.min-1 x 1.73 m-2; mean +/- SEM; P < 0.001). Respiratory quotient and oxidation rates for major fuels were not different between the total patient-group and controls. In patients without glucose supply, energy derived from fat was higher and from carbohydrate lower than in healthy controls and patients with glucose supply.
  
  
  CONCLUSIONS
  Energy expenditure is increased in acute liver failure. Altered substrate oxidation can be normalized by glucose supply.
authors.affiliation: Department of Internal Medicine IV, University of Vienna, Austria.
authors.forename: B
authors.initials: B
authors.lastname: Schneeweiss
authors.forename: J
authors.initials: J
authors.lastname: Pammer
authors.forename: K
authors.initials: K
authors.lastname: Ratheiser
authors.forename: B
authors.initials: B
authors.lastname: Schneider
authors.forename: C
authors.initials: C
authors.lastname: Madl
authors.forename: L
authors.initials: L
authors.lastname: Kramer
authors.forename: A
authors.initials: A
authors.lastname: Kranz
authors.forename: P
authors.initials: P
authors.lastname: Ferenci
authors.forename: W
authors.initials: W
authors.lastname: Druml
authors.forename: G
authors.initials: G
authors.lastname: Grimm
mesh_terms: D000328:Adult; D004734:Energy Metabolism; D005260:Female; D005947:Glucose / Q000378:metabolism; D006339:Heart Rate; D006801:Humans; D017114:Liver Failure, Acute / Q000378:metabolism*; D008297:Male; D010084:Oxidation-Reduction; D010101:Oxygen Consumption
chemical_list: D005947:Glucose