Hepatic extraction of indocyanine green is depressed early in sepsis despite increased hepatic blood flow and cardiac output
P. Wang, Z. F. Ba and I. H. Chaudry
Department of Surgery, Michigan State University, East Lansing 48824-1315.
Although active hepatocellular function is depressed during sepsis, it is
not known whether this occurs in the very early stages of sepsis and
whether it is due to depressed cardiac output or hepatic blood flow. To
study this, rats were subjected to sepsis by cecal ligation and puncture
and hepatocellular function was determined at various intervals thereafter
by assessing the ability of the liver to clear different doses of
indocyanine green. The indocyanine green concentration was continuously
measured in vivo with a fiberoptic catheter and an in vivo
hemoreflectometer. Maximal velocity and kinetic constant of the clearance
of indocyanine green, hepatic blood flow, and cardiac output were
determined in experimental and sham-operated rats. The results demonstrate
that hepatic blood flow and cardiac output increased 2 to 10 hours after
cecal ligation and puncture, while hepatocellular function (maximum
velocity and kinetic constant) was decreased even 2 hours following cecal
ligation and puncture. No linear correlation between hepatocellular
function and hepatic blood flow or cardiac output was found under such
conditions. The extremely early depression in active hepatocellular
function, despite the increased hepatic blood flow and cardiac output, may
form the basis for cellular dysfunctions leading to multiple organ failure
during sepsis.
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Gut-derived norepinephrine plays a critical role in producing hepatocellular dysfunction during early sepsis
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ABSTRACT
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FULL TEXT
Pentoxifylline prevents the transition from the hyperdynamic to hypodynamic response during sepsis
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ABSTRACT
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ABSTRACT
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