Altered hepatocellular active transport. An early change in peritonitis
I. H. Chaudry, S. Schleck, M. G. Clemens, T. E. Kupper and A. E. Baue
Multiple system failure is often the final result of severe infection that
cannot be controlled. The changes that may occur in remote organs and cells
in the early stages of sepsis and that may initiate this process have not
been defined. To study this, indocyanine green (ICG) clearance, serum
enzyme levels, and reticuloendothelial (RE) function were measured during
various stages of sepsis, which was produced in rats by cecal ligation and
puncture (CLP). The clearance of ICG decreased significantly during the
early stages of sepsis (five hours after CLP) at a time when there was no
change in the serum enzyme levels or RE function. Ten hours after CLP, RE
function was depressed, and serum enzyme levels were elevated. Progressive
changes in RE function and serum enzyme levels occurred in the late stages
of sepsis (16 hours after CLP). Since unaltered hepatic adenosine
triphosphate levels have been previously found, even ten hours after CLP,
humoral factor(s) may be responsible for altered ICG clearance in the early
stages of sepsis. Thus, hepatocellular dysfunction occurred early in the
course of sepsis and was manifested by a deficit in a plasma membrane
active transport process (ICG clearance). Indocyanine green clearance
provided an extremely sensitive early indication of a hepatic abnormality.
