Premium
Is there occult tissue ischemia in chronic end‐stage liver disease?
Author(s) -
Parker Brian M.,
Dishart Michael K.,
Pinsky Michael R.,
Kang Yoogoo
Publication year - 1999
Publication title -
liver transplantation and surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1074-3022
DOI - 10.1002/lt.500050305
Subject(s) - occult , pathological , medicine , ischemia , liver transplantation , stage (stratigraphy) , transplantation , cardiology , gastroenterology , pathology , biology , alternative medicine , paleontology
Whether pathological oxygen supply dependency exists in patients with chronic end‐stage liver disease (CESLD) is unknown, although the frequently occurring multiorgan dysfunction seen in these patients may be the result of occult tissue ischemia. In this study, 15 adult patients with CESLD were evaluated for the presence of pathological oxygen supply dependency and, thus, occult tissue ischemia before undergoing orthotopic liver transplantation. Whole‐body oxygen consumption (V o 2 )was measured using indirect calorimetry at baseline, at reduced oxygen delivery (D o 2 )using positive end‐expiratory pressure, and at increased D o 2 using volume infusion. As a group, no significant increase or decrease in V o 2 was observed with changes in D o 2 . However, 4 patients showed increases in V o 2 of 14%, 10.8%, 9.6%, and 8.2% when D o 2 was increased. The study results suggest that pathological oxygen supply dependency is present in a subset of patients with CESLD, and the existence of occult tissue ischemia is speculated.