COMBINED EFFECTS OF PROLONGED PROSTAGLANDIN E1-INDUCED HYPOTENSION AND HEMODILUTION ON HUMAN HEPATIC-FUNCTION

Combined effects of prolonged prostaglandin E1 (PGE1)-induced hypotens ion and haemodilution on hepatic function were studied in 30 patients undergoing hip surgery. The patients were randomly allocated to one of three groups; those in group A (n=10) were subjected to controlled hy potension alone, those in group B (n=10) to haemodilution alone and th ose in group C (n=10) to both controlled hypotension and haemodilution . Haemodilution in groups B and C was produced by withdrawing approxim ately 1000 mL of blood and replacing it with the same amount of dextra n solution, and final haematocrit values were 21 or 22%. Controlled hy potension in groups A and C was induced with PGE1 to maintain mean art erial blood pressure at 55 mmHg for 180 min. Measurements included art erial ketone body ratio (AKBR, aceto-acetate/3-hydroxybutyrate) and cl inical hepatic function parameters. AKBR and biological hepatic functi on tests showed no change throughout the time course in groups A and B . In group C, AKBR showed a significant decrease at 120 min (-40%) and at 180 min (-49%) after the start of hypotension and at 60 min (-32%) after recovery of normotension, and SGOT, SGPT, LDH and total bilirub in showed significant increases after operation. The results suggest t hat a prolonged combination of more than 120 min of PGE1-induced hypot ension and moderate haemodilution would cause impairment of hepatic fu nction.