Increased Lactate Appearance and Reduced Clearance During Hypoxia in Dogs

Summary

In order to assess the effects of severe hypoxia on whole body glucose and lactate kinetics, nine experiments were performed on anesthetized, ventilated mongrel dogs. [U-¹³C]glucose and [1-¹⁴C]lactate (n = 5), or [6-¹⁴C]glucose and [U-¹³C]lactate (n = 4) were infused using the primed-continuous infusion method. Cardiac output was measured by thermodilution. After a control period with 21% O₂, inspired O₂ was reduced for 90 minutes. Three of the experiments resulted in unstable hemodynamics and lactate levels, and are excluded from the mean data. Arterial PO₂ fell from a control level of 106.8 ± 11.9 to 24.2 ± 3.5 mmHg during the last 45 minutes of hypoxia, and O₂ transport fell to 52% of normoxic values. Arterial lactate concentration and the rate of appearance increased by 428% and 182%, respectively, from control to hypoxia. The metabolic clearance rate for lactate fell by 34%. Arterial glucose levels did not change significantly with hypoxia, but the rate of glucose disappearance rose by 70%, and the rate of glucose conversion to lactate increased 3-fold. It is concluded that acute severe hypoxia in anesthetized dogs causes 1) a large increase in arterial lactate levels, but no significant change in glycemia, 2) a large increase in the rate of lactate disappearance and only a small increase in the rate of glucose disappearance and 3) a fall in the metabolic clearance rate of lactate.

Key words

Anoxia - Carbohydrate Metabolism - Glucose - Oxygen - Shock - Tracer Methodology