Different Contribution of Splanchnic Organs to Hyperlactatemia in Fecal Peritonitis and Cardiac Tamponade


Autoria(s): Gorrasi, José; Eleftheriadis, Anestis; Takala, Jukka; Brandt, Sebastian; Djafarzadeh, Siamak; Brügger, Lukas; Bracht, Hendrik; Jakob, Stephan
Data(s)

01/10/2013

Resumo

Background. Changes in hepatosplanchnic lactate exchange are likely to contribute to hyperlactatemia in sepsis. We hypothesized that septic and cardiogenic shock have different effects on hepatosplanchnic lactate exchange and its contribution to hyperlactatemia. Materials and Methods. 24 anesthetized pigs were randomized to fecal peritonitis (P), cardiac tamponade (CT), and to controls ( per group). Oxygen transport and lactate exchange were calculated during 24 hours. Results. While hepatic lactate influx increased in P and in CT, hepatic lactate uptake remained unchanged in P and decreased in CT. Hepatic lactate efflux contributed 20% (P) and 33% (CT), respectively, to whole body venous efflux. Despite maintained hepatic arterial blood flow, hepatic oxygen extraction did not increase in CT. Conclusions. Whole body venous lactate efflux is of similar magnitude in hyperdynamic sepsis and in cardiogenic shock. Although jejunal mucosal pCO2 gradients are increased, enhanced lactate production from other tissues is more relevant to the increased arterial lactate. Nevertheless, the liver fails to increase hepatic lactate extraction in response to rising hepatic lactate influx, despite maintained hepatic oxygen consumption. In cardiac tamponade, regional, extrasplanchnic lactate production is accompanied by hepatic failure to increase oxygen extraction and net hepatic lactate output, despite maintained hepatic arterial perfusion.

Formato

application/pdf

Identificador

http://boris.unibe.ch/54234/1/Different%20Contribution%20of%20Splanchnic%20Organs%20to%20Hyperlactatemia%20in%20Fecal%20Peritonitis%20and%20Cardiac%20Tamponade.pdf

Gorrasi, José; Eleftheriadis, Anestis; Takala, Jukka; Brandt, Sebastian; Djafarzadeh, Siamak; Brügger, Lukas; Bracht, Hendrik; Jakob, Stephan (2013). Different Contribution of Splanchnic Organs to Hyperlactatemia in Fecal Peritonitis and Cardiac Tamponade. BioMed research international, 2013, pp. 1-8. Hindawi Publishing Corporation 10.1155/2013/251084 <http://dx.doi.org/10.1155/2013/251084>

doi:10.7892/boris.54234

info:doi:10.1155/2013/251084

urn:issn:2314-6133

Idioma(s)

eng

Publicador

Hindawi Publishing Corporation

Relação

http://boris.unibe.ch/54234/

Direitos

info:eu-repo/semantics/openAccess

Fonte

Gorrasi, José; Eleftheriadis, Anestis; Takala, Jukka; Brandt, Sebastian; Djafarzadeh, Siamak; Brügger, Lukas; Bracht, Hendrik; Jakob, Stephan (2013). Different Contribution of Splanchnic Organs to Hyperlactatemia in Fecal Peritonitis and Cardiac Tamponade. BioMed research international, 2013, pp. 1-8. Hindawi Publishing Corporation 10.1155/2013/251084 <http://dx.doi.org/10.1155/2013/251084>

Palavras-Chave #610 Medicine & health
Tipo

info:eu-repo/semantics/article

info:eu-repo/semantics/publishedVersion

PeerReviewed