Hepatic blood flow and oxygen consumption in starvation, sepsis and septic shock.

Total hepatic and portal blood flow as well as hepatic and splanchnic oxygen consumption was measured in pigs in the normal fasted state and in the septic fasted state induced experimentally by cecal ligation. Pigs in the septic state were divided into two groupds, a septic high output state and a septic low output state, according to whether or not a pig showed a higher or lower cardiac output in the septic state than in the normal fasted state. In the septic high output state, the average cardiac output was 155 per cent of that during fasting; hepatic arterial flow increased 96 per cent, while portal flow decreased 19 per cent. Total hepatic blood flow increased slightly, 14 per cent. The ratio of total hepatic blood flow to cardiac output decreased from 42 per cent in the normal fasted state to 30 per cent. The total hepatic oxygen consumption increased 26 per cent because of significantly elevated oxygen transport by hepatic arterial flow. In the low output state, hepatic arterial flow significantly dropped, 74 per cent, while portal flow decreased slightly, 23 per cent, and total hepatic blood flow decreased 38 per cent. The decrease of cardiac output was less, 18 per cent. The ratio of total hepatic blood flow to cardiac output was 31 per cent. Total hepatic oxygen consumption decreased remarkably, 29.1 per cent, due chiefly to the decrease of hepatic arterial flow, and splanchnic oxygen consumption also decreased significantly, 22 per cent. Dissociation of hepatic arterial response to sepsis from the other gastrointestianl vessels caused a great difference in the hepatic oxygen consumption between the septic high output and the septic low output state, contributing in part to the difference in mortality between these two states.