Superior hepatic mitochondrial oxidation-reduction state in normothermic cardiopulmonary bypass

Abstract

Objective: This study is the first comparative investigation of hepatic blood flow and oxygen metabolism during normothermic and hypothermic cardiopulmonary bypass. Methods: Twenty-four patients undergoing coronary bypass operations were randomly divided into 2 groups according to their perfusion temperatures, either normothermia (36°C) or hypothermia (30°C). The clearance of indocyanine green was measured at 3 points. Arterial and hepatic venous ketone body ratios (an index of mitochondrial redox potential) and hepatic venous saturation were measured. Results: Hepatic blood flow in both groups was identical before, during, and after cardiopulmonary bypass (normothermia, 499 ± 111, 479 ± 139, and 563 ± 182 mL/min, respectively; hypothermia, 476 ± 156, 491 ± 147, and 560 ± 202 mL/min, respectively). The hepatic venous saturation levels were significantly lower during cardiopulmonary bypass in the normothermic group (normothermia, 41% ± 13%; hypothermia, 61% ± 18%; P 0.7) until the second postoperative day. However, the reduction in arterial ketone body ratio was less severe in the normothermic group. The difference in hepatic venous ketone body ratios was more obvious, and the hepatic venous ketone body ratios in the normothermic group were statistically superior to those of the hypothermic group throughout the course (P