Dopamine compensates for deterioration of hepatic hemodynamics and metabolism during occlusion and reperfusion of the hepatic artery
T. Kurokawa, T. Nonami, T. Ujita, A. Harada, A. Nakao and H. Takagi
University School of Medicine, Department of Surgery II, Nagoya, Japan.
OBJECTIVE: To investigate the effects of temporary hepatic arterial
occlusion and dopamine on hepatic hemodynamics and metabolism. DESIGN:
Experimental animal study in a dog model. The proper hepatic artery was
occluded for 60 minutes; then, it was reperfused for 60 minutes. Hepatic
hemodynamic and oxygen metabolic values, lactate uptake ratios, and blood
glucose levels were determined repeatedly throughout the experiment. Data
are given as mean +/- SE. INTERVENTION: In another group, dopamine
hydrochloride, 10 micrograms/kg per minute, was infused intravenously
throughout the experiment, and the same variables were recorded. RESULTS:
Portal vein blood flow continuously decreased during occlusion, and it
decreased even further after declamping of the hepatic artery; this led to
a disturbance of oxygen and lactate metabolism in the control group.
Dopamine increased the portal vein blood flow from 84.9% +/- 3.9% to 100.9%
+/- 3.6% of the preocclusion levels after 60-minute occlusion and from
79.0% +/- 3.6% to 93.6% +/- 5.1% of the preocclusion levels after 60-minute
reperfusion (P < .05, respectively). Dopamine also enhanced the hepatic
oxygen uptake ratio from 112.8% +/- 12.0% to 150.7% +/- 11.6% of the
preocclusion levels after 60-minute reperfusion (P < .05, respectively).
These factors contributed to acceleration of the hepatic oxygen consumption
and lactate uptake ratio in the group of dogs that were infused with
dopamine. CONCLUSIONS: Temporary occlusion of the hepatic artery causes
deterioration of hepatic hemodynamics and metabolism. Administration of
dopamine is an effective way to support hepatic function during occlusion
of the hepatic artery.
