Can we increase hepatic oxygen availability? The role of intentional hypercarbia

Our hypothesis is that hypercarbia produces sympathetic stimulant effect and local vasodilatation. We studied the effect of intentional hypercarbia (IHC) on hepatic venous oxygen saturation. The hepatic vein (HV) was cannulated in 15 patients through either the right internal jugular vein or the femoral vein to measure HV oxygen saturation and calculate oxygen content. The inferior vena cava (IVC) was cannulated in 6 patients above and below drainage of the hepatic veins for oxygen saturation and content difference along the IVC. IHC was achieved in awake patients by breathing oxygen enriched air at a flow rate of 2L/min for 10 min, and during anesthesia by increasing anesthetic dead space and reducing tidal volume. IHC increased HV blood oxygen saturation, decreased the arterio-hepatic vein oxygen content difference and decreased oxygen saturation difference and oxygen content difference along IVC.