Hepatic Perfusion and Splanchnic Oxygen Consumption in Patients Postinjury

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Abstract
Hepatic dysfunction following injury is due to hepatic ischemia, hepatic blood flow (HBF) and splanchnic O2 delivery and consumption were measured in 9 multiply injured patients. HBF, measured by indocyanine green clearance, was 0.4 .+-. 0.1 l/min per m2 12 after injury. It steadily increased to 1.3 .+-. 0.1 l/min per m2 by 1 wk after injury. Changes in cardiac output were similar and were due largely to changes in HBF. Hepatic hypoperfusion was correlated with subsequent increases in serum bilirubin. High O2 consumption was associated with high HBF and O2 delivery, and splanchnic O2 consumption became a large fraction (range, 21-67%) of total body O2 consumption. Although splanchnic O2 delivery was diminished with low HBF, splanchnic O2 consumption remained normal (37 .+-. 2 ml/min per m2) due to increased O2 extraction. Hepatic blood flow is markedly reduced after injury. Reduced HBF is correlated with liver dysfunction although normal splanchnic O2 consumption is maintained.