Combined effects of prolonged prostaglandin E1-induced hypotension and haemodilution on human hepatic function.
Combined effects of prolonged prostaglandin E1 (PGE1)-induced hypotension and haemodilution on hepatic function were studied in 30 patients undergoing hip surgery. The patients were randomly allocated to one of three groups; those in group A (n = 10) were subjected to controlled hypotension alone, those in group B (n = 10) to haemodilution alone and those in group C (n = 10) to both controlled hypotension and haemodilution. Haemodilution in groups B and C was produced by withdrawing approximately 1000 mL of blood and replacing it with the same amount of dextran solution, and final haematocrit values were 21 or 22%. Controlled hypotension in groups A and C was induced with PGE1 to maintain mean arterial blood pressure at 55 mmHg for 180 min. Measurements included arterial ketone body ratio (AKBR, aceto-acetate/3-hydroxybutyrate) and clinical hepatic function parameters. AKBR and biological hepatic function tests showed no change throughout the time course in groups A and B. In group C, AKBR showed a significant decrease at 120 min (-40%) and at 180 min (-49%) after the start of hypotension and at 60 min (-32%) after recovery of normotension, and SGOT, SGPT, LDH and total bilirubin showed significant increases after operation. The results suggest that a prolonged combination of more than 120 min of PGE1-induced hypotension and moderate haemodilution would cause impairment of hepatic function.
Fukusaki
M
M
Department of Anaesthesia, Nagasaki Rosai Hospital, Sasebo, Japan.
Maekawa
T
T
Yamaguchi
K
K
Matsumoto
M
M
Shibata
O
O
Sumikawa
K
K
D000328:Adult; D000368:Aged; D000527:Alprostadil / Q000009:adverse effects*; D001784:Blood Gas Analysis; D004311:Double-Blind Method; D005260:Female; D006438:Hemodilution / Q000009:adverse effects*; D006439:Hemodynamics / Q000502:physiology; D006615:Hip / Q000601:surgery; D006801:Humans; D007023:Hypotension, Controlled / Q000009:adverse effects*; D007657:Ketone Bodies / Q000097:blood; D008099:Liver / Q000187:drug effects / Q000502:physiology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged
D007657:Ketone Bodies; D000527:Alprostadil