In:
American Journal of Physiology-Gastrointestinal and Liver Physiology, American Physiological Society, Vol. 323, No. 4 ( 2022-10-01), p. G348-G361
Kurzfassung:
Impaired oxygen utilization has been proposed to play a significant role in sepsis-induced liver dysfunction, but its magnitude and temporal course during prolonged resuscitation is controversial. The aim of this study is to evaluate the capability of the liver to increase oxygen extraction in sepsis during repeated acute portal vein blood flow reduction. Twenty anesthetized and mechanically ventilated pigs with hepatic hemodynamic monitoring were randomized to fecal peritonitis or controls ( n = 10, each). After 8-h untreated sepsis, the animals were resuscitated for three days. The ability to increase hepatic O 2 extraction was evaluated by repeated, acute decreases in hepatic oxygen delivery (Do 2 ) via reduction of portal flow. Blood samples for liver function and liver biopsies were obtained repeatedly. Although liver function tests, ATP content, and Do 2 remained unaltered, there were signs of liver injury in blood samples and overt liver cell necrosis in biopsies. With acute portal vein occlusion, hepatic Do 2 decreased more in septic animals compared with controls [max. decrease: 1.66 ± 0.68 mL/min/kg in sepsis vs. 1.19 ± 0.42 mL/min/kg in controls; portal venous flow (Qpv) reduction-sepsis interaction: P = 0.028]. Hepatic arterial buffer response (HABR) was impaired but recovered after 3-day resuscitation, whereas hepatic oxygen extraction increased similarly during the procedures in both groups (max. increase: 0.27 ± 0.13 in sepsis vs. 0.18 ± 0.09 in controls; all P 〉 0.05). Our data indicate maintained capacity of the liver to acutely increase O 2 extraction, whereas blood flow regulation is transiently impaired with the potential to contribute to liver injury in sepsis. NEW & NOTEWORTHY The capacity to acutely increase hepatic O 2 extraction with portal flow reduction is maintained in sepsis with accompanying liver injury, but hepatic blood flow regulation is impaired.
Materialart:
Online-Ressource
ISSN:
0193-1857
,
1522-1547
DOI:
10.1152/ajpgi.00109.2022
Sprache:
Englisch
Verlag:
American Physiological Society
Publikationsdatum:
2022
ZDB Id:
1477329-6
SSG:
12
