Skip to main content
SpringerLink
Log in

The role of the liver in the changes of acid-base balance and plasma lipids during surface-induced deep hypothermia

  • Published:
The Japanese journal of surgery Aims and scope Submit manuscript

Abstract

The role of the liver in the changes of acid-base balance and plasma lipids in surface-induced deep hypothermia for open-heart surgery was investigated clinically and experimentally. The metabolic acidosis generally observed in open-heart surgery under surface-induced deep hypothermia is derived from lactacidemia. Although the accelerated anaerobic glycolysis is partly responsible, the depressed acidic metabolite-disposing ability of the liver also plays an important role. The evidence which is presented to show the decrease of plasma lipids other than NEFA under hypothermia is probably due to the hepatic accumulation of lipids and the decreased lipids release from the liver.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ballinger, W.F., Vollenweider, H., Templeton, J.Y. and Pierucci, L. Jr.: Acidosis of hypothermia,Ann. Surg. 154: 517–523, 1961.

    Article  CAS  PubMed  Google Scholar 

  2. Baum, D., Dillard, D.H., Mohri, H. and Crawford, E.W.: Metabolic aspects of deep surgical hypothermia in infancy,Pediatrics 42: 93–105, 1968.

    PubMed  CAS  Google Scholar 

  3. Broder, G. and Weil, M.H.: Excess lactate. An index of reversibility of shock in human patients,Science 143: 1457–1459, 1964.

    PubMed  CAS  Google Scholar 

  4. Duncombe, W.G.: The colorimetric microdetermination of non-esterified fatty acids in plasma,Clin. chim. Acta. 9: 122–125, 1964.

    Article  PubMed  CAS  Google Scholar 

  5. Fletcher, M.J.: A colorimetric method for estimating serum triglycerides,Clin. chim. Acta. 22: 393–397, 1968.

    Article  PubMed  CAS  Google Scholar 

  6. Folch, R.H., Rubinstein, D., McGarry, E.F. and Beck, J.C.: Factors influencing the release of free fatty acids from rat adipose tissue,Endocrinology 69: 1009–1015, 1961.

    Article  Google Scholar 

  7. Fried, R. and Hoeflmayr, J.: Eine einfache indirekte Bestimmungsmethode der beta-Lipoproteine,Klin. Wschr. 41: 246–247, 1963.

    Article  PubMed  CAS  Google Scholar 

  8. Hoeflmayr, J. and Fried, R.: Eine rasch durch-fuhrbare Methode zur Bestimmung des freien Cholesterins,Med. Welt. Nr 38, 2015–2017, 1964.

    CAS  Google Scholar 

  9. Hoeflmayr, J. and Fried, R.: Eine Methode zu routinemassigen Bestimmung des Lipid-phosphors und Phosphatide,Med. U. Ernahr. 7: 9–10, 1966.

    Google Scholar 

  10. Horiuchi, T., Koyamada, K., Matano, I., Mohri, H., Komatsu, T., Honda, T., Abe, T., Ishitoya, T., Sagawa, Y., Matsuzawa, K., Matsumura, M., Tsuda, T., Ishizawa, E., Ishikawa, S., Suzuki, H. and Saito, Y.: Radical operation for ventricular septal defect in infancy,J. Thorac. Cardiovasc, Surg. 46: 180–190, 1963.

    CAS  Google Scholar 

  11. Mohri, H., Dillard, D.H., Crawford, E.W., Martin, W.E. and Merendino, K.A.: Method of surface-induced deep hypothermia for open-heart surgery in infants,J. Thorac. Cardiovasc. Surg. 58: 262–270, 1969.

    PubMed  CAS  Google Scholar 

  12. Moore, D. and Bernhard, W.F.: The prevention and treatment of acute metabolic complication associated with prolonged extracorporeal circulation,J. Thorac. Cardiovasc. Surg. 45: 565–573, 1963.

    CAS  Google Scholar 

  13. Okamura, H., Yonezawa, T., Seta, K. and Niitu, K.: Experimentelle und klinische Studien bei Operationen am offenen Herzen unter tiefer Hypothermie mit kardioplegischen Substanz,Langenbecks Arch. klin. Chir. 297: 593–633, 1961.

    Article  Google Scholar 

  14. Onodera, T.: Changes of portal blood in shock,Rinsho Seiri (Clinical Physiology) 1: 521–524, 1971 (in Japanese).

    Google Scholar 

  15. Peretz, D.I., Scott, H.M., Duff, J., Dossefor, J.B., McLean, L.D. and McGregor, M.: The significance of lactacidemia in the shock syndrome,Ann. N. Y. Acad. Sci. 119: 1133–1140, 1965.

    PubMed  CAS  Google Scholar 

  16. Richterich, R.: Clinical Chemistry, edited by Richterich, pp. 219–223, Academic Press, N.Y., 1969.

    Google Scholar 

  17. Rittenhouse, E.A., Mohri, H. and Merendino, K.A.: Studies of carbohydrate metabolism and serum electrolytes during surface-induced deep hypothermia with prolonged circulatory occulsion,Surgery 67: 995–1005, 1970.

    PubMed  CAS  Google Scholar 

  18. Schumer, W.: Lactic acid as a factor in the production of irreversibility in oligohaemic shock,Nature 212: 1210–1212, 1966.

    Article  CAS  Google Scholar 

  19. Shida, H., Morimoto, M., Seki, T. and Inokawa, K.: Metabolic changes in surface-induced deep hypothermia combined with cardiopulmonary bypass,Jap. J. Surg. 5: 73–83, 1975.

    Article  CAS  Google Scholar 

  20. Shida, H.: Pathogenesis and treatment of metabolic acidosis in open-heart surgery under surface-induced deep hypothermia,Jap. J. Surg. 4: 198–203, 1974.

    Article  CAS  Google Scholar 

  21. Shida, H., Morimoto, M., Inokawa, K., Iwasa, T., Yuzuriha, H. and Shirota, H.: Correlation between metabolic acidosis and removal of acid metabolite from the liver during open-heart surgery by simple profound hypothermia,Shinzo (Heart) 6: 1536–1542, 1974 (in Japanese).

    Google Scholar 

  22. Shigematsu, S.: On the changes of plasma and liver lipids associated with operative stress and on the correlation of them,Nippon Geka Gakkai Zasshi (Journal of Japanese Surgical Society) 69: 27–44, 1968 (in Japanese).

    Google Scholar 

  23. Stoffel, W., Chu, F. and Ahens, E.H. Jr.: Analysis of long-chain fatty acids by gasliquid chromatography,Anal. Biochem. 31: 307–308, 1959.

    CAS  Google Scholar 

  24. Vitek, V. and Cowley, R.A.: Blood lactate in the prognosis of various forms of shock,Ann. Surg. 173: 308–313, 1971.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Second Department of Surgery, Faculty of Medicine, Shinshu University, Matsumoto, Japan

    Hiroshi Shida, Masami Morimoto, Koichi Inokawa & Jiro Tsugane

Authors
  1. Hiroshi Shida
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Masami Morimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Koichi Inokawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jiro Tsugane
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shida, H., Morimoto, M., Inokawa, K. et al. The role of the liver in the changes of acid-base balance and plasma lipids during surface-induced deep hypothermia. The Japanese Journal of Surgery 7, 139–146 (1977). https://doi.org/10.1007/BF02469344

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02469344

Key Words

Search

Navigation