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Endotoxaemic liver injury in a porcine model--relation to tumour necrosis factor-alpha release and survival.

The effects of a continuous infusion of E. coli endotoxin on liver blood chemistry, plasma TNFalpha and blood pressure were evaluated in relation to survival in 18 anaesthetized pigs. The endotoxin infusion cause both unconjugated and conjugated bilirubin to increase (both p < 0.001), as compared to 6 saline-infused controls. Four pigs died during the endotoxin infusion. The plasma levels of TNFalpha of these 4 non-survivors were higher compared to TNFalpha of the 14 surviving endotoxaemic pigs (p < 0.05). The increase in plasma bilirubin of the non-survivors was less expressed (p < 0.05), and their arterial blood pressure and base excess deteriorated (both p < 0.001) compared to surviving endotoxaemic pigs. A decreased blood pressure explains both the reduced 'hepatic washout' of bilirubin and visceral ischaemia, reflected by the development of metabolic acidosis. This porcine model may be suitable for studying endotoxaemic liver injury.