Effects of Ringer's acetate solution during transient hepatic inflow occlusion in rabbits

This study aimed to clarify the difference in the effects of sodium acetate and sodium lactate administration on hepatic energy metabolism during hepatic warm ischemia and reperfusion. In the first experiment, Ringer's acetate (AR) or Ringer's lactate (LR) solutions were administered intravenously during 20 min of hepatic inflow occlusion in rabbits. Blood gas analyses and measurements of blood pressure, pyruvate, lactate, and ketone body concentrations in arterial blood were performed until 30 min of reperfusion. Hepatic tissue adenine nucleotide concentrations were determined at the end of the experiment. With AR administration, the plasma pyruvate level and the ratio of pyruvate to lactate were significantly elevated during reperfusion. Hepatic energy charge at 30 min of reperfusion improved significantly (P < 0.001) with AR compared with LR administration. Plasma ketone body concentrations decreased markedly with LR administration, but were maintained with AR administration. In the second experiment, intravenous administration of AR or LR, hepatic ischemia, and reperfusion were similarly performed in rabbits. Ketone body concentrations were determined in arterial and vena cava blood at 0 min, 20 min of inflow occlusion, and 30 min of reperfusion. With AR administration, a large arteriovenous difference in ketone body concentrations was observed, indicating utilization in the peripheral tissues. With LR administration, no arteriovenous difference was observed. Availability of energy substrate in peripheral tissues by administration of AR is thought to decrease the metabolic load to the liver and to improve hepatic energy status during reperfusion.