The effect of exogenous substrate on hepatic metabolism and membrand transport during endotoxemia.

Endotoxemia in dogs reduced hepatic uptake and biliary excretion of indocyanine green dye. This diminished active membrane transport was associated with reduced hepatocyte membrane potential difference. Studies of arteriovenous concentration differences and flow across the liver demonstrated that endotoxemia increased hepatic glucose and lactate production and decreased oxygen consumption. Correction of this energy deficit occurred following infusion of glucose and insulin, but not after administration of isocaloric quantities of intravenous amino acids. The glucose-insulin infusion during endotoxemia shifted the liver back to an organ of glucose uptake, improved oxygen consumption, and provided the necessary energy for normal dye transport and maintenance of the normal membrane potential difference.