Abstract
The Limulus amoebocyte lysate assay was used as one of a series of laboratory and clinical investigations on a group of 31 patients suffering from septic shock in order to assess the clinical significance of this assay for the detection of circulating endotoxin in clinical gram-negative sepsis. Four patients with cardiogenic shock served as controls. Endotoxin was detected in the bloodstream of all patients with septic shock during the 24 h following referral and was not detected in the control patients. Eventual clinical recovery was associated with the disappearance of endotoxin from the peripheral blood. Blood cultures were unhelpful as a prognostic indicator in these critically ill patients. A quantitative assay of endotoxin in blood may allow a more precise relationship with the clinical manifestations of major sepsis.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bailey ME (1976) Endotoxin, bile salts and renal function in instructure jaundice. Br J Surg 63:774
Clements GB (Unpublished observations)
Du Bose DA, Le Maire M, Basamania K, Rowlands J (1980) Comparison of plasma extraction techniques in preparation of samples for endotoxin testing by the Limulus amoebocyte lysate test. J Clin Microbiol 11:68
elin RJ (1979) Clinical utility of the Limulus test with blood, CSF and synovial fluid. In: Cohen E (ed) Biomedical applications of the Horseshoe Crab (Limulidae). Alan R Liss, New York, p 279
Fossard DP, Kakkar VV (1976) The Limulus test in experimental and clinical endotoxaemia. Br J Surg 61:798
Fossard DP, Kakkar VV, Elsey Penelope A (1974) Assessment of limulus test for detecting endotoxaemia. Br Med J 61:465
Goto H, Nakamura S (1980) Liberation of endotoxin fromEscherichia coli by addition of antibiotics. Japan J Exp Med 50:35
Iwanaga S, Morita T, Harada T, Nakamura S, Niwa M, Takada K, Kimura T, Sakakibara S (1978) Chromogenic substrates for horseshoe crab clotting enzyme — its application for the assay of bacterial endotoxins. Haemostasis 7:183
Jacob AI, Goldberg PK, Bloom N, Degenshein GA, Kozim PJ (1977) Endotoxin and bacterial in portal blood. Gastroenterology 72:1268
Ledingham IMcA, Bradley JA, McCartney AC, Redding PJ (1983) Infection and septic shock. In: Bain WH, Taylor KM (eds) Handbook of intensive care. John Wright, London (in press)
Ledingham IMcA, McArdle CS (1978) Prospective study of the treatment of septic shock. Lancet 1:1194
Levin J (1979) The Limulus test: a status report. In: Cohen E (ed) Biomedical applications of the Horseshoe Crab (Limulidae). Alan R Liss, New York, p 235
Levin J, Tomasulo PA, Oser RS (1970) Detection of endotoxin in human blood and demonstration of an inhibitor. J Lab Clin Med 75:903
Lucie NP, Browning JD, Smillie DM, Ledingham IMcA (1980) Platelet count and other haematological measurements in septic shock. J Clin Pathol 33:890
McGovern VJ (1972) The pathophysiology of gram-negative shock. Pathol 4:265
Nakamura S, Morita S, Iwanaga M, Niva M, Takahashi K (1977) A sensitive substrate for the clotting enzyme in horseshoe crab haemocytes. J Biochem (Tokyo) 81:1567
Reinhold RB, Fine J (1971) A technique for quantitative measurement of endotoxin in human plasma. Proc Soc Exp Biol Med 137:334
Scovill WA, Saba TM, Blumenstock FA, Bernard H, Powers SR (1978) Opsonic α2 surface binding glycoprotein therapy during sepsis. Ann Surg 188:521
Scully MF, Newman YM, Clark SE, Kakkar VV (1980) Evaluation of a chromogenic method for endotoxin measurement. Thromb Res 20:263
Siegel SE, Nachum R (1977) Use of the Limulus lysate assay (LAL) for the detection and quantitation of endotoxin. In: Bernheimer AW (ed) Perspectives on toxinology. John Wiley, New York, p 61
Sim AJW, McCartney A Christine (1980) The appearance of endotoxin following urethral instrumentation. Br J Surg 67:443
Sullivan JD Jr, Valois FW, Watson SW (1976) Endotoxins: the limulus amoebocyte lysate system. In: Bernheimer AW (ed) Mechanisms in bacterial toxinology. John Wiley, New York p 217
Wiles JB, Cerra FB, Siegel JH, Border JR (1980) The systemic septic response: does the organism matter? Crit Care Med 8:55
Wilkinson SP, Moodie H, Stamatakis JD, Kakkar VV, Williams R (1976) Endotoxaemia and renal failure in cirrhosis and obstructive jaundice. Br Med J 2:1415
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
McCartney, A.C., Banks, J.G., Clements, G.B. et al. Endotoxaemia in septic shock: Clinical and post mortem correlations. Intensive Care Med 9, 117–122 (1983). https://doi.org/10.1007/BF01772577
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01772577