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Vol. 84, Issue 3, 791-797, March 1998
Department of Research and Development, Veterans Affairs Medical Center, Pittsburgh 15240; and Departments of Anesthesiology and Critical Care Medicine, Internal Medicine, and Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania 15261
Dysoxia can
be defined as ATP flux decreasing in proportion to
O2 availability with preserved ATP
demand. Hepatic venous
-hydroxybutyrate-to-acetoacetate ratio
(
-OHB/AcAc) estimates liver mitochondrial NADH/NAD and may detect
the onset of dysoxia. During partial dysoxia (as opposed to anoxia),
however, flow may be adequate in some liver regions, diluting effluent
from dysoxic regions, thereby rendering venous
-OHB/AcAc unreliable.
To address this concern, we estimated tissue ATP while
gradually reducing liver blood flow of swine to zero in a nuclear
magnetic resonance spectrometer. ATP flux decreasing with
O2 availability was taken as
O2 uptake
(
O2) decreasing in
proportion to O2 delivery
(
O2);
and preserved ATP demand was taken as increasing
Pi/ATP.
O2, tissue
Pi/ATP, and venous
-OHB/AcAc
were plotted against
O2
to identify critical inflection points. Tissue dysoxia required mean
O2
for the group to be critical for both
O2 and for
Pi/ATP. Critical
O2
values for
O2 and
Pi/ATP of 4.07 ± 1.07 and 2.39 ± 1.18 (SE) ml · 100 g
1 · min
1,
respectively, were not statistically significantly different but not
clearly the same, suggesting the possibility that dysoxia might have
commenced after
O2 began
decreasing, i.e., that there could have been
"O2 conformity." Critical
O2
for venous
-OHB/AcAc was 2.44 ± 0.46 ml · 100 g
1 · min
1
(P = NS), nearly the same as that for
Pi/ATP, supporting venous
-OHB/AcAc as a detector of dysoxia. All issues considered, tissue mitochondrial redox state seems to be an appropriate detector of
dysoxia in liver.
adenosine 5'-triphosphate; nuclear magnetic resonance; oxygen delivery; ischemia; pig
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