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1 Institute for Surgical
Research,
The role of
endotoxin (lipopolysaccharide, LPS) and nitric oxide in hepatic oxygen
metabolism was investigated in 36 pigs receiving
1) LPS (1.7 µg · kg
1 · h
1)
for 7 h and NG-nitro-L-arginine
methyl ester (L-NAME; 25 mg/kg)
after 3 h, 2) LPS,
3) NaCl and
L-NAME, and
4) NaCl. Infusion of LPS reduced hepatic oxygen delivery
(DO2H) from
60 ± 4 to 30 ± 5 ml/min (P < 0.05) and increased the oxygen extraction ratio from 0.29 ± 0.07 to
0.68 ± 0.04 after 3 h (P < 0.05). Hepatic oxygen consumption (
O2H) was maintained (18 ± 4 and 21 ± 4 ml/min, change not significant), but acidosis
developed. Administration of
L-NAME during endotoxemia caused
further reduction of
DO2H from
30 ± 3 to 13 ± 2 ml/min (P < 0.05) and increased hepatic oxygen extraction ratio from 0.46 ± 0.04 to 0.80 ± 0.03 (P < 0.05). There was a decrease in
O2H from 13 ± 2 to 9 ± 2 ml/min that did not reach statistical significance,
probably representing a type II error. Acidosis was aggravated.
Administration of L-NAME in the
absence of endotoxin also increased the hepatic oxygen extraction
ratio, but no acidosis developed. In a different experiment, liver
blood flow was mechanically reduced in the presence and absence of
endotoxin, comparable to the flow reductions caused by
L-NAME. The increase in hepatic oxygen extraction ratio (0.34) and maximum hepatic oxygen extraction ratio (~0.90) was similar whether
DO2H was
reduced by occlusion or by
L-NAME. We concluded that
L-NAME has detrimental
circulatory effects in this model. However, neither endotoxin nor
L-NAME seemed to prevent the
ability of the still circulated parts of the liver to increase hepatic
oxygen extraction ratio to almost maximum when oxygen delivery was
reduced. The effect of L-NAME on
oxygen transport thus seems to be caused by a reduction in
DO2H rather than by alterations in oxygen extraction capabilities.
NG-nitro-L-arginine methyl ester; liver circulation; liver oxygen consumption; septic shock
This article has been cited by other articles:
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