British Journal of Anaesthesia, Vol 76, Issue 5 713-720, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia
MFM. James, R. Hickman, P. Janicki, B. Mets and J. Fourie
In a previous study, we showed that plasma concentrations of catecholamines
were increased during the anhepatic phase in pigs. In this study, we
investigated if a constant depth of anaesthesia would prevent these changes
and, if not, if the changes were caused by impaired extraction of
catecholamines. We measured arterial and venous pressures, heart rate and
cardiac output in 10 anaesthetized pigs. Hepatic arterial and portal venous
flows were measured. Blood for measurement of catecholamines was sampled
from carotid and pulmonary arteries and portal, hepatic and renal veins.
After a 2-h observation period, the liver was removed and the circulation
reconstituted. Measurements were made and samples obtained for another 2 h.
Catecholamine concentrations increased 2-10-fold after hepatectomy. Before
hepatectomy, noradrenaline was extracted by the lung (mean extraction ratio
23 (SEM 8)%) and the liver (30 (11)%); after hepatectomy, there was
extraction by the kidney (24 (12)%) but extraction by the lung (29 (8)%)
was unchanged. Before hepatectomy, adrenaline was extracted predominantly
by the kidney (73 (5)%) and the liver (70 (6)%), with minimal extraction by
the lung; after hepatectomy, extraction by the lung increased (25 (4)%) and
decreased slightly in the kidney (56 (6)%). While mean arterial pressure
did not change, heart rate increased by approximately 50% and cardiac index
declined (ns) within 2 h after hepatectomy. There was a sharp increase in
pulmonary vascular resistance after removal of the liver and changes
correlated with increases in arterial plasma concentrations of
catecholamines.
LABORATORY INVESTIGATIONS
Early effects of total hepatectomy on haemodynamic state and organ uptake of catecholamines in the pig
Department of Anaesthesia, University of Cape Town, South Africa; Department of Surgery, University of Cape Town, South Africa; MRC Liver Centre, University of Cape Town, South Africa
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