Effect of dobutamine on serum bile acid levels in patients with cirrhosis

Abstract

To investigate whether improving hepatic blood flow is effective as a treatment for cirrhosis we measured cardiac output and hepatic blood flow in eight patients with cirrhosis and hepatocellular carcinoma (5 women and 3 men, aged 51 to 64 years) who were given dobutamine intravenously through a peripheral vein. The relationship between changes in hepatic blood flow and changes in total bile acid concentration in the peripheral blood were assessed. Hepatic blood flow was measured by using the xenon 133 gas clearance method with a catheter positioned in the portal vein. Dobutamine infusion increased cardiac output and hepatic blood flow to 133.9% and 111.4% of preinfusion values, respectively, and decreased total serum bile acid concentration 120 minutes after the start of infusion to 59.0% of the pretreatment value. The bile acids, in descending order of the highest percent decrease, were ursodeoxycholic, cholic, deoxycholic, chenodeoxycholic, and lithocholic; however, there were no significant differences between the free, glycine-conjugated, and taurine-conjugated forms. The percent decrease in total serum bile acids was significantly correlated with the percent increase in hepatic blood flow. These findings suggest that increasing blood flow could be an effective way to decrease total serum bile acid levels and thus possibly promote liver function in patients with cirrhosis