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Lactate Metabolism During Marginal Liver Perfusion

Vaughan Johnson, MD; E. Bielanski, BS; Ben Eiseman, MD
Arch Surg. 1969;99(1):75-79. doi:10.1001/archsurg.1969.01340130077014.
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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


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