TRIIODOTHYRONINE RESUSCITATES THE IMPAIRED LIVER-FUNCTION AFTER PRINGLES MANEUVER

Objective: To evaluate the changes in thyroid hormone levels and the effectiveness of exogenous triiodothyronine (T-3) in shock caused by prolonged use of Pringle's maneuver (cross-clamping of hepatic triads). Design: Pringle's maneuver was performed on dogs for 1 hour. In the T-3 group (n=7), 1 mu g/kg per hour of T-3 was administered intravenously for 3 hours after declamping. In the control group (n=7), the same volume of saline solution without T-3 was administered. Main Outcome Measures: Serum T-3, reverse T-3, thyroxine, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and the ketone body-ratio (AKBR), which reflect the hepatic energy charge, were measured. Tissue blood flow, tissue blood velocity, and tissue blood mass of the liver were measured by means of a laser Doppler flowmeter. Oxygen saturation of the hemoglobin in the liver tissue was measured by tissue near-infrared spectroscopy. Dogs were observed until the seventh postoperative day. Results: In the control group, the low T-3 syndrome was observed. None of the dogs recovered from the shock and none survived for more than 24 hours. In the T-3 group, all dogs recovered from the shock and survived. In the control group, hepatic tissue blood flow and oxygen saturation of hemoglobin in liver tissue were decreased, and the AKBR was deteriorated. In the T-3 group, however, these parameters were markedly improved. Conclusion: It is suggested that T-3 administration is beneficial in managing the critical resuscitation period of liver function after Pringle's maneuver is performed in dogs.