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Related Experiment Videos

Tissue hypoxia during fulminant hepatic failure.

D Bihari, A E Gimson, M Waterson

    Critical Care Medicine
    |December 1, 1985
    PubMed
    Summary

    In fulminant hepatic failure, lower systemic vascular resistance and impaired oxygen extraction indicate poor tissue oxygenation and predict mortality. This suggests arteriovenous shunting contributes to organ failure in these patients.

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    Area of Science:

    • Hepatology
    • Critical Care Medicine
    • Physiology

    Background:

    • Fulminant hepatic failure (FHF) presents a critical challenge in intensive care.
    • Assessing tissue oxygenation is vital for managing FHF and predicting outcomes.

    Purpose of the Study:

    • To evaluate tissue oxygenation adequacy in patients with FHF and grade IV encephalopathy.
    • To identify physiological parameters correlating with survival in FHF.

    Main Methods:

    • Measured arterial oxygen delivery, hemoglobin-oxygen affinity (P50), mixed venous oxygen tension, and lactate.
    • Analyzed systemic vascular resistance (SVR) and oxygen extraction ratio (O2ER) in survivors versus non-survivors.

    Main Results:

    • Nonsurvivors had significantly lower SVR and O2ER, but higher oxygen delivery compared to survivors.

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  • Nonsurvivors exhibited elevated in vivo P50 and mixed venous lactate levels.
  • A correlation between in vivo P50 and O2ER was observed only in survivors.

    • Conclusions:

    • Reduced SVR in FHF may indicate arteriovenous shunting, more severe in non-survivors.
    • Tissue hypoxia, indicated by impaired oxygen extraction, is a critical prognostic factor in FHF.
    • These factors contribute to the development of irreversible multiple organ failure in FHF.