A Predominant Increase of Arterial β-Hydroxybutyrate Concentration during Partial Hepatectomies in Patients with Impaired Indocyanine Green Clearance Test

Background.It has been reported that a concentration ratio of two ketone bodies, [acetoacetate]/[β-hydroxybutyrate], reflects the redox state in the liver mitochondria, but there are few reports which examined each ketone body concentration during hepatectomy. Materials and Methods.(1) Ketone body l...

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Published in:The Journal of surgical research 1999-02, Vol.81 (2), p.243-248
Main Authors: Higashi, Shushi, Tabata, Naoto, Kondo, Kazu-Hiro, Kai, Masahiro, Miyamoto, Koji, Maeda, Yorio, Setoguchi, Toshiaki
Format: Article
Language:English
Subjects:
3-Hydroxybutyric Acid - blood
Acetoacetates - blood
Biological and medical sciences
Coloring Agents - pharmacokinetics
Female
Functional investigation of the digestive system
hepatectomy
Hepatectomy - methods
Hepatic Veins
Humans
Indocyanine Green - pharmacokinetics
Investigative techniques, diagnostic techniques (general aspects)
Ketone Bodies - blood
ketone body
Liver Diseases - surgery
Liver Neoplasms - surgery
Male
Medical sciences
Metabolic Clearance Rate
Middle Aged
Radial Artery
Regression Analysis
β-hydroxybutyrate
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Summary:Background.It has been reported that a concentration ratio of two ketone bodies, [acetoacetate]/[β-hydroxybutyrate], reflects the redox state in the liver mitochondria, but there are few reports which examined each ketone body concentration during hepatectomy. Materials and Methods.(1) Ketone body levels in the radial artery and the hepatic vein were measured simultaneously during hepatectomies in 12 patients. (2) Arterial ketone body levels were measured during hepatectomies (at three points) in 73 patients. Results.(1) Both ketone body levels in the radial artery well reflected those in the hepatic vein (P< 0.001). (2) There was no change in the arterial acetoacetate level. The level of β-hydroxybutyrate increased significantly from 30.4 to 76.5 μmol/L (P< 0.005) only in the group of 25 patients with seriously impaired indocyanine green clearance test. Conclusions.Ketosis during hepatectomy was caused by increased β-hydroxybutyrate, and this phenomenon was observed only in patients with seriously impaired liver function.
ISSN:0022-4804
1095-8673
DOI:10.1006/jsre.1998.5462