Hepatic parenchymal oxygen tension following injury and sepsis
M. S. Dahn, R. F. Wilson, P. Lange, A. Stone and L. A. Jacobs
Department of Surgery, Veterans Administration Medical Center, Detroit, Mich.
Hepatic blood flow and splanchnic oxygen consumption were measured in 16
injured (n = 6) or septic (n = 10) patients and compared with values in 16
normal volunteers. Sepsis and injury appeared to stimulate an increase in
blood flow and oxygen utilization, with the highest levels observed in the
septic group. Patients with sepsis exhibited a 72% and 60% increase in
hepatic blood flow and splanchnic oxygen consumption, respectively,
compared with normal volunteers. Application of these data to the
Krogh-Erlang tissue model indicates that despite an increase in oxygen
delivery to the splanchnic bed during sepsis, it becomes more sensitive to
hypoxic/ischemic events compared with other patient groups. This is
indicated by a reduced centrilobular and increased critical oxygen tension.
The major factor responsible for this is the regional hypermetabolism
present in sepsis. This analysis emphasizes the critical importance of
maintaining oxygen transport in critically ill patients with sepsis.
