Metabolic Effects of Ringer's Acetate Solution During Hepatic Inflow Occlusion in the Dog

Abstract

We compared the effects of infusions of Ringer's lactate (LR) and acetate (AR) solutions, on acid-base balance and hepatic energy metabolism during 40 min of hepatic inflow occlusion and 30 min of reperfusion in dogs. A slightly milder acidosis was observed in the group receiving AR, compared with the group receiving LR. After 40 min of occlusions in the LR group, ketone body concentrations in arterial and venous blood markedly decreased to a comparable level, indicating no uptake of ketone bodies in peripheral tissues. In contrast, in the group given AR, ketone body concentrations did not decrease during the inflow occlusion. Both the arterial concentration and arterio-venous concentration gradients were maintained, indicating sufficient supply and utilization of ketone bodies in the peripheral tissues. Moreover, the renal-venous concentration of ketone bodies was slightly higher than the arterial concentration, indicating renal ketogenesis during hepatic inflow occlusion in dogs receiving AR infusions. The hepatic energy levels (ATP+1/2ADP) in the AR group were significantly higher than in the LR group after 30 min of reperfusion. Due to the improved acid-base balance and sufficient ketone body supply to peripheral tissues, the metabolic burden of the liver after release of occlusion was considered to be smaller in the AR group. AR administration during hepatic ischemia is recommended.