Effects of systemic arterial hypoperfusion on splanchnic hemodynamics and hepatic arterial buffer response in pigs.
The hepatic arterial buffer response (HABR) tends to maintain liver blood flow under conditions of low mesenteric perfusion. We hypothesized that systemic hypoperfusion impairs the HABR. In 12 pigs, aortic blood flow was reduced by cardiac tamponade to 50 ml. kg(-1). min(-1) for 1 h (short-term tamponade) and further to 30 ml. kg(-1). min(-1) for another hour (prolonged tamponade). Twelve pigs without tamponade served as controls. Portal venous blood flow decreased from 17 +/- 3 (baseline) to 6 +/- 4 ml. kg(-1). min(-1) (prolonged tamponade; P = 0.012) and did not change in controls, whereas hepatic arterial blood flow decreased from 2 +/- 1 (baseline) to 1 +/- 1 ml. kg(-1). min(-1) (prolonged tamponade; P = 0.050) and increased from 2 +/- 1 to 4 +/- 2 ml. kg(-1). min(-1) in controls (P = 0.002). The change in hepatic arterial conductance (DeltaC(ha)) during acute portal vein occlusion decreased from 0.1 +/- 0.05 (baseline) to 0 +/- 0.01 ml. kg(-1). min(-1). mmHg(-1) (prolonged tamponade; P = 0.043). In controls, DeltaC(ha) did not change. Hepatic lactate extraction decreased, but hepatic release of glutathione S-transferase A did not change during cardiac tamponade. In conclusion, during low systemic perfusion, the HABR is exhausted and hepatic function is impaired without signs of cellular damage.
Jakob
S M
SM
Critical Care Research Program, Department of Anesthesiology and Intensive Care, Kuopio University Hospital, FIN-70210 Kuopio, Finland. stephan.jakob@insel.ch
Tenhunen
J J
JJ
Laitinen
S
S
Heino
A
A
Alhava
E
E
Takala
J
J
D000818:Animals; D001012:Aorta, Abdominal / Q000502:physiology / Q000503:physiopathology; D001783:Blood Flow Velocity / Q000502:physiology*; D001794:Blood Pressure; D002196:Capillaries / Q000502:physiology / Q000503:physiopathology; D002302:Cardiac Output; D002305:Cardiac Tamponade / Q000503:physiopathology; D005260:Female; D005753:Gastric Mucosa / Q000098:blood supply; D006339:Heart Rate; D006439:Hemodynamics / Q000502:physiology*; D006499:Hepatic Artery / Q000502:physiology* / Q000503:physiopathology; D006706:Homeostasis; D007413:Intestinal Mucosa / Q000098:blood supply; D007583:Jejunum / Q000098:blood supply; D007773:Lactates / Q000097:blood; D008102:Liver Circulation / Q000502:physiology; D011169:Portal Vein / Q000502:physiology / Q000503:physiopathology; D011652:Pulmonary Circulation / Q000502:physiology; D012016:Reference Values; D012039:Regional Blood Flow; D013152:Splanchnic Circulation / Q000502:physiology*; D013552:Swine; D013997:Time Factors
D007773:Lactates