- Meeting abstract
- Open Access
Influence of iloprost on hepato splanchnic metabolic activity and energy balance in patients with septic shock
© Current Science Ltd 2000
- Published: 21 March 2000
- Septic Shock
- Lactate Clearance
Septic shock is characterized by increased splanchnic blood flow due to enhanced metabolic activity. Endogenous prostacyclin may be crucial to maintain liver function and gastric mucosal integrity . Therefore we studied the effect of intravenous. iloprost on hepatosplanchnic metabolic activity and energy balance in patients with septic shock.
Twelve patients with septic shock (cardiac index, CI ≥ 3 l/min×m2, all requiring noradrenaline≥ 0.03 μg/kg×min-1 to maintain mean arterial pressure (MAP ≥ 70 mmHg) were studied. In addition to routine systemic hemodynamics and gas exchange we inserted a Swan Ganz catheter into a hepatic vein (hv) to measure splanchnic blood flow using primed continuous infusion of indocyanine-green. Moreover, we assessed splanchnic lactate uptake (Fick principle), endogenous glucose production rate (stable isotope approach), as well as hepatic venous lactate/pyruvate and acetoacetate/β-OH-butyrate ratios. Measurements obtained after 90' of hemodynamic steady-state were recorded before, after and during iloprost infusion titrated to obtain a 20% increase in CI (0.9–3 ng/kg×min-1).
See Table. Friedmann test/Student-Newman-Keuls: *P<0.05 vs baseline.
Sys. DO2 ml/min/m2
Sys. VO2 ml/min/m2
Spl. DO2 ml/min/m 2
Spl. VO2 ml/min/m 2
Spl. Lactate balance μmol/kg/min
Glucose production μmol/kg/min
Supported by Deutsche Forschungsgemeinschaft (Ra 396/4-1); Schering - Germany