ENTERAL FEEDING MINIMIZES LIVER-INJURY DURING HEMORRHAGIC-SHOCK

Liver injury is common in patients following hemorrhage and sepsis. Th ere are multiple etiologies for this liver injury which involve both d ecreased nutrient blood flow and direct cellular injury. Enteral nutri ents vasodilate gut blood vessels and increase blood flow to the intes tines and liver. Since enteral nutrients vasodilate gut blood vessels, we wondered whether luminal nutrition would prevent hepatic injury du ring shock states. We randomized Sprague-Dawley rats to saline or ente ral nutrition via duodenal feeding tubes. Animals were then subjected to 60 min of hemorrhagic hypotension or intraperitoneal injection of l ipopolysaccharide (LPS). Liver injury was assessed by measuring levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT ) before and after hemorrhage or LPS. Enteral nutrients significantly decreased liver injury following hemorrhage. AST increased from 246 +/ - 17 to 1605 +/- 593 U/L in saline animals and 283 +/- 39 to 551 +/- 9 4 U/L in enterally fed animals. ALT increased from 60 +/- 4 to 726 +/- 355 U/L in saline animals and 61 +/- 6 to 161 +/- 38 U/L in enterally fed animals. Enteral nutrients did not significantly alter the increa se in AST/ALT following LPS. These results indicate that enteral nutri ents can decrease liver injury following hemorrhagic hypotension.