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  • Title: [Liver perfusion and oxygenation with isoflurane].
    Author: Hobbhahn J, Conzen P, Goetz A, Habazettl H, Brendel W, Peter K.
    Journal: Anasth Intensivther Notfallmed; 1986 Apr; 21(2):85-9. PubMed ID: 3728892.
    Abstract:
    The influence of 0.7, 1.4 or 2.1 vol % isoflurane on hepatic blood flow and hepatic tissue oxygenation was studied in 12 dogs under basal anaesthesia with i.v. piritramid. Blood flow was measured by the microsphere method (phi = 15 micron). Tissue pO2 was determined by a platinum multiwire electrode and by measuring hepatic venous pO2. Isoflurane effected a marked fall in arterial blood pressure in these surgically not stimulated animals. However, cardiac output fell only moderately due to a considerable reduction in systemic vascular resistance. Both local tissue pO2 and venous pO2 were decreased with isoflurane. A potentially hazardous reduction in hepatic tissue pO2 was found predominantly with high isoflurane concentrations. The decrease in hepatic tissue pO2 results from disadvantageous effects on hepatic O2-balance: total hepatic blood flow decreases, whereas splanchnic O2 consumption increases. The lower blood flow is due to a reduction of portal blood flow whereas arterial perfusion remains unchanged. The increase in splanchnic O2 consumption possibly results from an elevated O2 consumption of the liver. Further studies have to clarify whether the disadvantageous effects of high isoflurane concentrations fail to appear when pain-induced stimulation of the sympathico-adrenergic system counteracts the fall in arterial blood pressure.
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