Open AccessEndotoxemia and Bacteremia During Hemorrhagic Shock The Link Between Trauma and Sepsis?
Author(s) -
Benjamin Rush,
Alan J. Sori,
Thomas F. Murphy,
Sharon Smith,
John J. Flanagan,
George W. Machiedo
Publication year - 1988
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-198805000-00009
Subject(s) - medicine , bacteremia , sepsis , shock (circulatory) , blood pressure , incidence (geometry) , septic shock , hemorrhagic shock , blood stream , anesthesia , antibiotics , microbiology and biotechnology , physics , optics , biology
Previous investigations of a treated model of hemorrhagic shock in the rat indicated the frequent occurrence of bacteremia that appeared to derive from the gut. This paper determines the incidence of bacteremia and endotoxemia during the acute shock period and compares this with similar observations in humans in varying degrees of shock. Studies in 26 rats indicated that bacteremia and endotoxemia was present in 50% and 87%, respectively, by the end of 2 hours at a mean arterial pressure of 30 mmHg. Observations in 50 patients admitted to the trauma unit showed that positive bacterial blood cultures were present in 56% when the admission systolic blood pressure was 80 mmHg or less (p less than 0.01 compared with either of the other groups). Endotoxemia was noticed in two such patients. Direct access of bacteria and endotoxin to the blood stream may occur during hemorrhagic or traumatic shock and is the probable cause of subsequent sepsis in traumatized patients when no other source is apparent.