Nakatani T, Ishikawa Y, Kobayashi K, Ozawa K
Trauma and Critical Care Center, Teikyo University School of Medicine, Tokyo, Japan.
Intensive Care Med. 1991;17(2):103-7. doi: 10.1007/BF01691432.
Arterial blood ketone body ratio, reflecting hepatic mitochondrial redox state, was measured in 26 brain-dead patients who were hypotensive but hemodynamically stable. All of them had substantially normal hepatic function. In 18 of the patients, blood ketone body ratio was maintained within the normal range in spite of hypotension. This was in marked contrast to the markedly decreased blood ketone body ratio often observed in patients in shock. This phenomenon was especially conspicuous in those who had not received exogenous dopamine infusion. It is suggested that hepatic mitochondrial redox state can probably be maintained despite systemic hypotension in brain-dead patients. Dopamine administration, on the other hand, is suggested to be a contributing factor to the reduction of hepatic mitochondrial redox state in hypotensive brain-dead patients. This study may provide a guideline for effective preservation of hepatic function in the body of brain-dead patients.
