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Splanchnic metabolism associated with liver metastasis
M S Dahn1, M P Lange, M A Kosir
1Department of Surgery, University Health Center, Detroit, MI 48201, USA.
Intensive Care Medicine
|April 1, 1995
Summary
Metastatic liver disease can worsen critical illness by increasing lactic acidosis. Highly active tumors may cause regional hypermetabolism, leading to hepatic hypoxia and complicating metabolic assessments.
Area of Science:
- Critical Care Medicine
- Oncology
- Hepatology
Background:
- Metastatic liver disease significantly impacts metabolic responses during critical illness.
- Systemic lactic acidosis in critical illness can stem from increased production or impaired hepatic clearance.
Observation:
- A patient with metastatic melanoma and adult respiratory distress syndrome showed a significant oxygenation disparity between systemic and hepatic circulation.
- This disparity was linked to heightened splanchnic oxygen utilization without a corresponding increase in oxygen delivery.
Findings:
- Increased metabolic activity of metastatic liver lesions may drive regional hypermetabolism.
- This hypermetabolism can exacerbate hepatic hypoxia and worsen lactic acidosis.
Implications:
- Metastatic liver tumors can contribute to metabolic dysfunction and lactic acidosis in critically ill patients.
- Interpreting global metabolic and oxygenation indicators is challenging in such complex cases.