Huckabee has shown that during shock and hypotension there is an accumulation of excess lactate.1 In previous studies, we2,3 have shown that lactated Ringer's solution is effective in the resuscitation from hemorrhagic shock in both the experimental animal and in man, and does not result in accumulation of the exogenous lactate load. Lactate is converted to pyruvate mainly in the liver,4 but small amounts are metabolized by the kidney5 and myocardium.6
Although these studies demonstrate that during marked hypotension there is essentially normal metabolism of lactate, there inevitably must be a minimal point of liver perfusion at which lactate is no longer converted to pyruvate.
The purpose of this study is to determine the minimal liver blood flow at which exogenous lactate no longer is metabolized.
Materials and Methods
Variable Rates of Hepatic Artery and Portal Venous Flow (Part 1).—Utilizing an isolated pig
Johnson V, Bielanski E, Eiseman B. Lactate Metabolism During Marginal Liver Perfusion. Arch Surg. 1969;99(1):75–79. doi:10.1001/archsurg.1969.01340130077014
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: