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Hepatic O2 exchange and liver energy metabolism in hyperdynamic porcine endotoxemia: effects of iloprost.
- Source :
-
Intensive care medicine [Intensive Care Med] 2000 Oct; Vol. 26 (10), pp. 1531-9. - Publication Year :
- 2000
-
Abstract
- Objective: To compare the effects of a 12 h continuous infusion of iloprost, a stable prostacyclin analogue, on hepatic blood flow (Qliv), O2 exchange, and energy metabolism during a 24 h hyperdynamic, porcine endotoxemia with volume resuscitation alone.<br />Design: Prospective, randomized, experimental study with repeated measures.<br />Setting: Investigational animal laboratory.<br />Subjects: Twenty-eight domestic pigs: 16 animals during endotoxemia with volume resuscitation alone (ETX), 12 with endotoxemia, volume resuscitation, and treatment with iloprost (ILO).<br />Interventions: Endotoxemia was initiated by continuous infusion of E. coli lipopolysaccharide. Animals were resuscitated with hetastarch, aimed at maintaining a MAP of > 60 mmHg. After 12 h of endotoxemia, iloprost was administered for 12 h in the treatment group, titrated to avoid pharmacologically induced hypotension (MAP < 60 mmHg).<br />Measurements and Results: Iloprost significantly increased Qliv, with no effect on hepatic O2 delivery. Mean capillary hemoglobin O2 saturation (HbScO2) on the liver surface, as well as HbScO2 frequency distributions--a measure of microcirculatory O2 availability--remained unchanged. Treatment with iloprost, however, significantly attenuated the endotoxin-induced derangements of cellular energy metabolism as reflected by the diminished progressive decrease in hepatic lactate uptake rate and a blunted increase in hepatic venous lactate/pyruvate ratios. While endotoxin significantly increased endogenous glucose production (EGP) rate, iloprost restored EGP to normal at the end of the experiment.<br />Conclusions: Thus, in a clinically relevant model of human sepsis, iloprost did not produce potential adverse effects but rather ameliorated hepatic metabolic disturbances and, thereby, hepatic energy balance.
- Subjects :
- Animals
Blood Gas Analysis
Drug Evaluation, Preclinical
Endotoxemia microbiology
Endotoxemia physiopathology
Escherichia coli
Escherichia coli Infections microbiology
Escherichia coli Infections physiopathology
Female
Fluid Therapy methods
Hemodynamics drug effects
Hemoglobins analysis
Iloprost pharmacology
Lactic Acid metabolism
Lipopolysaccharides
Liver blood supply
Male
Microcirculation drug effects
Prospective Studies
Pyruvic Acid metabolism
Random Allocation
Resuscitation methods
Swine
Time Factors
Vasodilator Agents pharmacology
Disease Models, Animal
Endotoxemia drug therapy
Endotoxemia metabolism
Energy Metabolism drug effects
Escherichia coli Infections drug therapy
Escherichia coli Infections metabolism
Iloprost therapeutic use
Liver drug effects
Liver metabolism
Oxygen Consumption drug effects
Vasodilator Agents therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 0342-4642
- Volume :
- 26
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Intensive care medicine
- Publication Type :
- Academic Journal
- Accession number :
- 11126268
- Full Text :
- https://doi.org/10.1007/s001340000645