TRIIODOTHYRONINE RESUSCITATES THE IMPAIRED LIVER-FUNCTION AFTER PRINGLES MANEUVER

Objective: To evaluate the changes in thyroid hormone levels and the e ffectiveness of exogenous triiodothyronine (T-3) in shock caused by pr olonged use of Pringle's maneuver (cross-clamping of hepatic triads). Design: Pringle's maneuver was performed on dogs for 1 hour. In the T- 3 group (n=7), 1 mu g/kg per hour of T-3 was administered intravenousl y for 3 hours after declamping. In the control group (n=7), the same v olume of saline solution without T-3 was administered. Main Outcome Me asures: Serum T-3, reverse T-3, thyroxine, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and the ketone body-ratio (AKBR ), which reflect the hepatic energy charge, were measured. Tissue bloo d flow, tissue blood velocity, and tissue blood mass of the liver were measured by means of a laser Doppler flowmeter. Oxygen saturation of the hemoglobin in the liver tissue was measured by tissue near-infrare d spectroscopy. Dogs were observed until the seventh postoperative day . Results: In the control group, the low T-3 syndrome was observed. No ne of the dogs recovered from the shock and none survived for more tha n 24 hours. In the T-3 group, all dogs recovered from the shock and su rvived. In the control group, hepatic tissue blood flow and oxygen sat uration of hemoglobin in liver tissue were decreased, and the AKBR was deteriorated. In the T-3 group, however, these parameters were marked ly improved. Conclusion: It is suggested that T-3 administration is be neficial in managing the critical resuscitation period of liver functi on after Pringle's maneuver is performed in dogs.