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Alterations in Hepatic Water and Electrolyte Balance in Sepsis

Alterations in Hepatic Water and Electrolyte Balance in Sepsis Abstract • Since decreased nutrient flow has been proposed as the cause of hepatocellular dysfunction during sepsis, we studied hepatic Na+ and K+ balance in rats with sepsis to determine if these changes were consistent with ischemia-induced hepatocellular damage. Sepsis was produced in rats by cecal ligation and puncture (CLP). Seventeen to 19 hours following CLP, the rats were found to have late sepsis but not septic shock. At this time, either hepatic and RBC Na+ and K+ were determined in vivo, or the livers were isolated and perfused with Krebsbicarbonate buffer for 30 minutes prior to determining hepatic tissue Na+ and K+ levels. In contrast to previous reports of hemorrhagic shock and following hepatic ischemia, there was a significant increase in hepatic K+ in vivo and after 30 minutes of isolated perfusion in vitro. No significant changes were detected in RBC Na+ or K+. Thus, although decreased hepatic nutrient flow may develop during sepsis, hypoperfusion is not the cause of hepatocellular dysfunction. (Arch Surg 1984;119:44-48) References 1. Baue AE, Chaudry IH: Prevention of multiple systems failure . Surg Clin North Am 1980;60:1167-1178. 2. MacLean LD, Mulligan W, McLean A, et al: Patterns of septic shock in man: A detailed study of 56 patients . Ann Surg 1967;166:543-558.Crossref 3. Duff J, Groves A, McLean A, et al: Defective oxygen consumption in septic shock . Surg Gynecol Obstet 1969;128:1051. 4. Udhoji VN, Weil MH: Hemodynamic and metabolic studies on shock associated with bacteremia . Ann Intern Med 1965;62:966.Crossref 5. Garrison RN, Ratcliffe DJ, Fry DE: Hepatocellular function and nutrient blood flow in experimental peritonitis . Surgery 1982;92:713-719. 6. Fitch KA, Rink RD: Hepatic oxygen supply during early and late sepsis in the rat . Circ Shock 1983;10:51-59. 7. Schumer W, Das Gupta T, Moss G, et al: Effect of endotoxemia on liver cell mitochondria in man . Ann Surg 1970;171:875-882.Crossref 8. Mela L, Bacalzo L, Miller L: Defective oxidative metabolism of rat liver mitochondria in hemorrhagic and endotoxin shock . Am J Physiol 1971;220: 571. 9. Filkins JP, Cornell RP: Depression of hepatic gluconeogenesis and the hypoglycemia of endotoxin shock . Am J Physiol 1974;227:778-781. 10. Guillem JG, Clemens MG, Chaudry IH, et al: Hepatic gluconeogenic capability in sepsis is depressed before changes in oxidative capability . J Trauma 1982;22:723-729.Crossref 11. Clemens MG, Chaudry IH, McDermott PH, et al: Regulation of glucose production from lactate in experimental sepsis . Am J Physiol 1983;244:R794-R800. 12. Pearce FJ, Weiss PR, Miller JR, et al: Effect of hemorrhage, anoxia and graded ischemia on hepatic gluconeogenesis . Surg Forum 1982;33:3-5. 13. Wichterman KA, Chaudry IH, Baue AE: Studies of peripheral glucose uptake during sepsis . Arch Surg 1979;114:740-745.Crossref 14. Williams JA, Woodbury DM: Determination of extracellular space and intracellular electrolytes in rat liver in vivo . J Physiol 1971;212:85-99. 15. Chaudry IH, Sayeed MM, Baue AE: Depletion and restoration of tissue ATP in hemorrhagic shock . Arch Surg 1974;108:208-211.Crossref 16. Bergmeyer HV: Methods of Enzymatic Analysis . New York, Academic Press Inc, 1975, p 1205. 17. Ohkawa M, Chaudry IH, Clemens MG, et al: Hepatic mitochondrial responses to sepsis and septic shock . Circ Shock 1983;10:273. 18. Sayeed MM, Adler RJ, Chaudry IH, et al: Effect of hemorrhagic shock on hepatic transmembrane potentials and intracellular electrolytes, in vivo . Am J Physiol 1981;240:R211-R219. 19. Ohkawa M, Chaudry IH, Clemens MG, et al: Improvement in water and electrolyte moneostasis by ATP-MgCl2 after ischemia . Circ Shock 1982;9:162. 20. Van Rossum GDV: The relation of sodium and potassium ion transport to the respiration and adenine nucleotide content of liver slices treated with inhibitors of respiration . Biochem J 1972;129:427-438. 21. Clemens MG, Chaudry IH, Baue AE: Hepatic membrane potentials in early and late sepsis . Circ Shock 1983;10:245. 22. Friedmann N, Somlyo AV, Somlyo AP: Cyclic adenosine and guanosine monophosphates and glucagon: Effect on liver membrane potentials . Science 1971;171:400-403.Crossref 23. Haylett DG, Jenkinson DH: Effects of noradrenaline on the membrane potential and ionic permeability of parenchymal cells in the liver of the guineapig . Nature 1969;224:80-81.Crossref 24. Egashira K: Biphasic response to noradrenaline in the guinea pig liver cells . Jpn J Physiol 1980;30:81-91.Crossref 25. Illner H, Shires GT: Changes in sodium, potassium and adenosine triphosphate contents of red blood cells in sepsis and septic shock . Circ Shock 1982;9:259-267. 26. Cunningham JN, Shires GT, Wagner IY: Changes in intracellular sodium and potassium content of red blood cells in trauma and shock . Am J Surg 1971;122:650-654.Crossref 27. Kreis DJ, Chaudry IH, Schleck S, et al: Red blood cell sodium, potassium and ATP levels during hemorrhagic shock . J Surg Res 1981;31:225-231.Crossref 28. Filkins JP: Role of the RES in the pathogenesis of endotoxic hypoglycemia . Circ Shock 1982;9:269-280. 29. Mortimore GE: Effect of insulin on potassium transfer in isolated rat liver . Am J Physiol 1961;200:1315-1319. 30. Pilkis SJ, Park CR, Claus TH: Hormonal control of hepatic gluconeogenesis . Vitam Horm 1978;36:383-460. 31. Friedmann N, Dambach G: Antagonistic effect of insulin on glucagon-evoked hyperpolarization: A correlation between changes in membrane potential and gluconeogenesis . Biochim Biophys Acta 1980;596:180-185.Crossref 32. Wondergem R: Insulin depolarization of rat hepatocytes in primary monolayer culture . Am J Physiol 1983;244:C17-C23. 33. Ghosh S, Liu MS: Changes in α-adrenergic receptors in dog livers during endotoxin shock . J Surg Res 1983;34:239-245.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Alterations in Hepatic Water and Electrolyte Balance in Sepsis

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References (31)

Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1984.01390130034006
Publisher site
See Article on Publisher Site

Abstract

Abstract • Since decreased nutrient flow has been proposed as the cause of hepatocellular dysfunction during sepsis, we studied hepatic Na+ and K+ balance in rats with sepsis to determine if these changes were consistent with ischemia-induced hepatocellular damage. Sepsis was produced in rats by cecal ligation and puncture (CLP). Seventeen to 19 hours following CLP, the rats were found to have late sepsis but not septic shock. At this time, either hepatic and RBC Na+ and K+ were determined in vivo, or the livers were isolated and perfused with Krebsbicarbonate buffer for 30 minutes prior to determining hepatic tissue Na+ and K+ levels. In contrast to previous reports of hemorrhagic shock and following hepatic ischemia, there was a significant increase in hepatic K+ in vivo and after 30 minutes of isolated perfusion in vitro. No significant changes were detected in RBC Na+ or K+. Thus, although decreased hepatic nutrient flow may develop during sepsis, hypoperfusion is not the cause of hepatocellular dysfunction. (Arch Surg 1984;119:44-48) References 1. Baue AE, Chaudry IH: Prevention of multiple systems failure . Surg Clin North Am 1980;60:1167-1178. 2. MacLean LD, Mulligan W, McLean A, et al: Patterns of septic shock in man: A detailed study of 56 patients . Ann Surg 1967;166:543-558.Crossref 3. Duff J, Groves A, McLean A, et al: Defective oxygen consumption in septic shock . Surg Gynecol Obstet 1969;128:1051. 4. Udhoji VN, Weil MH: Hemodynamic and metabolic studies on shock associated with bacteremia . Ann Intern Med 1965;62:966.Crossref 5. Garrison RN, Ratcliffe DJ, Fry DE: Hepatocellular function and nutrient blood flow in experimental peritonitis . Surgery 1982;92:713-719. 6. Fitch KA, Rink RD: Hepatic oxygen supply during early and late sepsis in the rat . Circ Shock 1983;10:51-59. 7. Schumer W, Das Gupta T, Moss G, et al: Effect of endotoxemia on liver cell mitochondria in man . Ann Surg 1970;171:875-882.Crossref 8. Mela L, Bacalzo L, Miller L: Defective oxidative metabolism of rat liver mitochondria in hemorrhagic and endotoxin shock . Am J Physiol 1971;220: 571. 9. Filkins JP, Cornell RP: Depression of hepatic gluconeogenesis and the hypoglycemia of endotoxin shock . Am J Physiol 1974;227:778-781. 10. Guillem JG, Clemens MG, Chaudry IH, et al: Hepatic gluconeogenic capability in sepsis is depressed before changes in oxidative capability . J Trauma 1982;22:723-729.Crossref 11. Clemens MG, Chaudry IH, McDermott PH, et al: Regulation of glucose production from lactate in experimental sepsis . Am J Physiol 1983;244:R794-R800. 12. Pearce FJ, Weiss PR, Miller JR, et al: Effect of hemorrhage, anoxia and graded ischemia on hepatic gluconeogenesis . Surg Forum 1982;33:3-5. 13. Wichterman KA, Chaudry IH, Baue AE: Studies of peripheral glucose uptake during sepsis . Arch Surg 1979;114:740-745.Crossref 14. Williams JA, Woodbury DM: Determination of extracellular space and intracellular electrolytes in rat liver in vivo . J Physiol 1971;212:85-99. 15. Chaudry IH, Sayeed MM, Baue AE: Depletion and restoration of tissue ATP in hemorrhagic shock . Arch Surg 1974;108:208-211.Crossref 16. Bergmeyer HV: Methods of Enzymatic Analysis . New York, Academic Press Inc, 1975, p 1205. 17. Ohkawa M, Chaudry IH, Clemens MG, et al: Hepatic mitochondrial responses to sepsis and septic shock . Circ Shock 1983;10:273. 18. Sayeed MM, Adler RJ, Chaudry IH, et al: Effect of hemorrhagic shock on hepatic transmembrane potentials and intracellular electrolytes, in vivo . Am J Physiol 1981;240:R211-R219. 19. Ohkawa M, Chaudry IH, Clemens MG, et al: Improvement in water and electrolyte moneostasis by ATP-MgCl2 after ischemia . Circ Shock 1982;9:162. 20. Van Rossum GDV: The relation of sodium and potassium ion transport to the respiration and adenine nucleotide content of liver slices treated with inhibitors of respiration . Biochem J 1972;129:427-438. 21. Clemens MG, Chaudry IH, Baue AE: Hepatic membrane potentials in early and late sepsis . Circ Shock 1983;10:245. 22. Friedmann N, Somlyo AV, Somlyo AP: Cyclic adenosine and guanosine monophosphates and glucagon: Effect on liver membrane potentials . Science 1971;171:400-403.Crossref 23. Haylett DG, Jenkinson DH: Effects of noradrenaline on the membrane potential and ionic permeability of parenchymal cells in the liver of the guineapig . Nature 1969;224:80-81.Crossref 24. Egashira K: Biphasic response to noradrenaline in the guinea pig liver cells . Jpn J Physiol 1980;30:81-91.Crossref 25. Illner H, Shires GT: Changes in sodium, potassium and adenosine triphosphate contents of red blood cells in sepsis and septic shock . Circ Shock 1982;9:259-267. 26. Cunningham JN, Shires GT, Wagner IY: Changes in intracellular sodium and potassium content of red blood cells in trauma and shock . Am J Surg 1971;122:650-654.Crossref 27. Kreis DJ, Chaudry IH, Schleck S, et al: Red blood cell sodium, potassium and ATP levels during hemorrhagic shock . J Surg Res 1981;31:225-231.Crossref 28. Filkins JP: Role of the RES in the pathogenesis of endotoxic hypoglycemia . Circ Shock 1982;9:269-280. 29. Mortimore GE: Effect of insulin on potassium transfer in isolated rat liver . Am J Physiol 1961;200:1315-1319. 30. Pilkis SJ, Park CR, Claus TH: Hormonal control of hepatic gluconeogenesis . Vitam Horm 1978;36:383-460. 31. Friedmann N, Dambach G: Antagonistic effect of insulin on glucagon-evoked hyperpolarization: A correlation between changes in membrane potential and gluconeogenesis . Biochim Biophys Acta 1980;596:180-185.Crossref 32. Wondergem R: Insulin depolarization of rat hepatocytes in primary monolayer culture . Am J Physiol 1983;244:C17-C23. 33. Ghosh S, Liu MS: Changes in α-adrenergic receptors in dog livers during endotoxin shock . J Surg Res 1983;34:239-245.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Jan 1, 1984

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