Effect of continuous infusion of prostaglandin E1 on hepatic blood flow.

STUDY OBJECTIVE

To evaluate the effects of an intravenous infusion of prostaglandin E1 (PGE1) on hepatic blood flow.

DESIGN

Prospective clinical study.

SETTING

University-affiliated hospital.

PATIENTS

16 ASA physical status I and II surgical patients who were scheduled for abdominal surgery.

INTERVENTIONS

Patients were anesthetized with 1% sevoflurane and 66% nitrous oxide. PGE1 0.05 mg/kg/min or PGE1 0.10 mg/kg/min was continuously infused, followed by an infusion of 1000 mL Ringer's acetate solution.

MEASUREMENTS

The hemodynamic effect of PGE1 was examined using pulse dye densitometry (PDD). A nose probe for PDD was used, and 10 mg indocyanine green (ICG) in 2 mL distilled water was bolus-infused into a central venous catheter for each measurement. Cardiac output (CO), circulating blood volume (CBV), and plasma dye clearance rate (K) were monitored from the dye-densitogram. Hepatic blood flow was estimated using the K and CBV values.

MAIN RESULTS

PGE1 did not increase CBV or CO. Even adding a 1000 mL crystalloid infusion did not expand CBV, whereas mean arterial pressure (MAP) significantly decreased from 91.1 +/- 16.5 mmHg to 84.8 +/- 13.5 mmHg (PGE1 0.05 microg/kg/min) and 80.6 +/- 14.4 mmHg (PGE1 0.10 microg/kg/min ) (p < 0.01 compared with control value), then to 72.0 +/- 6.5 mmHg (PGE1 0.10 microg/kg/min + 1000 mL Ringer's acetate) (p < 0.01 compared with control value). Hepatic blood flow changes were 1.46 +/- 0.60 L/min (control), 1.48 +/- 0.45 L/min (PGE1 0.05 microg/kg/min), 1.14 +/- 0.35 L/min (PGE1 0.10 microg/kg/min), and 1.15 +/- 0.19 L/min (PGE1 0.10 microg/kg/min + 1000 mL Ringer's acetate) (no significant difference, p < 0.05). Hepatic blood flow and K values did not statistically significantly differ at each condition.

CONCLUSIONS

PGE1 does not affect blood volume shift, CO, or hepatic blood flow.