Whether pathological oxygen supply dependency exists in patients with chron
ic end-stage liver disease (CESLD) is unknown, although the frequently occu
rring multiorgan dysfunction seen in these patients may be the result of oc
cult tissue ischemia. In this study, 15 adult patients with CESLD were eval
uated for the presence of pathological oxygen supply dependency and, thus,
occult tissue ischemia before undergoing orthotopic liver transplantation.
Whole-body oxygen consumption (Vo(2)) was measured using indirect calorimet
ry at baseline, at reduced oxygen delivery (Do(2)) using positive end-expir
atory pressure, and at increased Do(2) using Volume infusion. As a group, n
o significant increase or decrease in Vo(2) was observed with changes in Do
(2), However, 4 patients showed increases in Vo(2) of 14%, 10.8%, 9.6%, and
8.2% when Do(2) was increased, The study results suggest that pathological
oxygen supply dependency is present in a subset of patients with CESLD, an
d the existence of occult tissue ischemia is speculated. Copyright (C) 1999
by the American Association for the Study of Liver Diseases.