The relationship between hepatic and cardiac function during hemorrhagic shocks in dogs.

The standard Wiggers' method was used to induce hemorrhagic shock in 13 anesthetized dogs by bleeding to a mean arterial pressure (MAP) of 50 mm Hg for 2 hours and then to 30 mm Hg for 1 hour, followed by reinfusion of the shed blood. The experimental protocol was designed to determine and relate hepatic function to cardiac function during hemorrhagic shock. Cardiac function parameters were recorded throughout the experiment on a multichannel polyoscillograph monitor, while liver function tests were done by using an automatic analyzer. Indices for cardiac performance, that is, left ventricular pressure (LVP), max dp/dt of LVP, left ventricular stroke work (LVSW), and right ventricular stroke work (RVSW) were all shown to be severely depressed at terminal stage. Transaminases (SGOT and SGPT) and lactate dehydrogenase (LDH), both being hepatic rich intracellular enzymes were very much elevated at terminal stage. This suggested that hepatic cell injury occurs in hemorrhagic shock as these enzymes seem to be leaking from damaged cells into bloodstream. Hepatic cell damage was confirmed to be present as the LDH isoenzyme electrophoresis showed a high frequency of liver fraction peak 5. Centrolobular hepatic necrosis was revealed by light microscopy. Cardiac function deterioration in hemorrhagic shock aggravates hepatic dysfunction.