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George W. Machiedo, MD; Thelma Hurd, MD; Benjamin F. Rush, Jr, MD; George Dikdan, MS; John McGee; Thomas Lysz, PhD

Arch Surg. 1988;123(4):424-427.

Abstract
• To determine whether hepatic dysfunction in sepsis results from hypoperfusion or direct cellular injury, SpragueDawley rats underwent either cecal ligation and puncture or sham operation. After either two or six hours, effective hepatic blood flow was measured using the galactose clearance method. Hepatocytes were isolated and intracellular sodium and potassium and glucose production were measured. Hepatic blood flow in septic rats decreased as early as two hours after sepsis when compared with sham-operated rats (3.8±1.4 vs 8.7±3.1 mL/min/100 g body weight). Intracellular sodium and potassium levels and glucose production in septic rats were not significantly different when compared with controls at two hours. After six hours, hepatic blood flow remained depressed and intracellular sodium level was increased compared with sham-operated rats (41.7±10.4 vs 31.4±5.9 mmol/L [41.7±10.4 vs 31.4±5.9 mEq/L]) and potassium decreased compared with controls (90.7±7.9 vs 111.5±6.7 mmol/L [90.7±7.9 vs 111.5±6.7 mEq/L]). Glucose production was decreased in septic rats after six hours when compared with controls (4.7±1.5 vs 15.4±6.4 µmol/g hepatocytes). These data suggest that hepatic blood flow is decreased before alterations in intracellular sodium and potassium as well as glucose production.

(Arch Surg 1988;123:424-427)

Author Affiliations
From the Surgical Service, Veterans Administration Medical Center, East Orange, NJ; and the Department of Surgery, University of Medicine and Dentistry—New Jersey Medical School, Newark.

Footnotes
Accepted for publication Sept 24, 1987.

Read before the Association of Veterans Administration Surgeons, Portland, Ore, May 8, 1987.

Reprint requests to Department of Surgery, MSB-G 530, New Jersey Medical School, 185 S Orange Ave, Newark, NJ 07103 (Dr Machiedo).

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