title: Effect of meal and propranolol on whole body and splanchnic oxygen consumption in patients with cirrhosis.
abstract: Our aim was to measure whole body energy expenditure after a mixed liquid meal, with and without simultaneous propranolol infusion, in patients with cirrhosis. We also wanted to investigate the effect of propranolol on substrate fluxes and oxygen uptake in the tissues drained by the hepatic vein and azygos vein in the postprandial period in these patients. Whole-body oxygen uptake, hepatic blood flow, hepatic venous pressure gradient and net-hepatic fluxes of oxygen, lactate, glucose, glycerol, and free fatty acids (FFA) were measured in 12 patients with alcoholic cirrhosis before and for 2 h after ingestion of a mixed liquid meal (700 kcal). Half of the patients (n = 6) were randomized to a treatment group receiving intravenous infusion of propranolol in combination with the meal. The meal-induced energy expenditure was significantly lower in patients given propranolol [15.0 +/- 18.9 vs. 67.0 +/- 26.1 kJ/120 min (means +/- SD), P < 0.01]. Meal-induced whole body oxygen uptake was lower in patients receiving propranolol (19.2 +/- 38 vs. 135.7 +/- 61 mmol/120 min, P < 0.01), and the meal-induced increase in splanchnic oxygen uptake was nonexistent when propranolol was administered in combination (-13.2 +/- 34.8 vs. 110.4 +/- 34.8 mmol/120 min, P = 0.04). Postprandially, the propranolol group had a tendency toward a reduced splanchnic glucose output, and the FFA uptake was significantly reduced. Propranolol reduces meal-induced whole body oxygen uptake and energy expenditure as well as splanchnic oxygen uptake. The splanchnic reduction in oxygen consumption can explain almost the entire reduction in whole body oxygen consumption.
authors.affiliation: Department of Gastroenterology, Hvidovre Hospital, Kettegaard Allé 30, 2650 Hvidovre, Denmark. Aleksander.Krag@hh.hosp.dk
authors.forename: Aleksander
authors.initials: A
authors.lastname: Krag
authors.forename: Lene
authors.initials: L
authors.lastname: Simonsen
authors.forename: Jens H
authors.initials: JH
authors.lastname: Henriksen
authors.forename: Lone
authors.initials: L
authors.lastname: Ottesen
authors.forename: Flemming
authors.initials: F
authors.lastname: Bendtsen
mesh_terms: D004305:Dose-Response Relationship, Drug; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008103:Liver Cirrhosis / Q000378:metabolism*; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D009928:Organ Specificity; D010100:Oxygen / Q000378:metabolism*; D010101:Oxygen Consumption / Q000187:drug effects*; D019518:Postprandial Period; D011433:Propranolol / Q000008:administration & dosage*; D013152:Splanchnic Circulation / Q000187:drug effects*; D014018:Tissue Distribution
chemical_list: D011433:Propranolol; D010100:Oxygen