OBJECTIVES: The roles of cytokines and endotoxin in hemorrhagic shock, particularly the translocation of endotoxin and bacteria during hemorrhagic shock, were investigated. DESIGN: Prospective study. SETTING: Critical care and emergency center of a university hospital. PATIENTS: Twenty-nine patients with hemorrhagic shock and 20 healthy controls. INTERVENTIONS: Serial blood samples were collected from both study and control patients. Standard resuscitation techniques were used. MEASUREMENTS AND MAIN RESULTS: Plasma levels of endotoxin and various cytokines were determined repeatedly during hemorrhagic shock. Endotoxin was measured using an endotoxin-specific assay in addition to a new perchloric acid method for pretreatment of plasma. Cytokines were measured by commercial enzyme-linked immunosorbent assays. Plasma endotoxin concentrations remained within the normal range for 7 days after admission. Although levels of tumor necrosis factor-alpha and several interleukins increased slightly in some patients, these cytokines did not reach the levels seen in septic shock. CONCLUSIONS: Translocation of bacteria or endotoxin from the gastrointestinal tract into the bloodstream has been noted in animal experiments; however, translocation was not detected in our patients with hemorrhagic shock.
OBJECTIVES: The roles of cytokines and endotoxin in hemorrhagic shock, particularly the translocation of endotoxin and bacteria during hemorrhagic shock, were investigated. DESIGN: Prospective study. SETTING: Critical care and emergency center of a university hospital. PATIENTS: Twenty-nine patients with hemorrhagic shock and 20 healthy controls. INTERVENTIONS: Serial blood samples were collected from both study and control patients. Standard resuscitation techniques were used. MEASUREMENTS AND MAIN RESULTS: Plasma levels of endotoxin and various cytokines were determined repeatedly during hemorrhagic shock. Endotoxin was measured using an endotoxin-specific assay in addition to a new perchloric acid method for pretreatment of plasma. Cytokines were measured by commercial enzyme-linked immunosorbent assays. Plasma endotoxin concentrations remained within the normal range for 7 days after admission. Although levels of tumor necrosis factor-alpha and several interleukins increased slightly in some patients, these cytokines did not reach the levels seen in septic shock. CONCLUSIONS: Translocation of bacteria or endotoxin from the gastrointestinal tract into the bloodstream has been noted in animal experiments; however, translocation was not detected in our patients with hemorrhagic shock.
Authors: Jose M Prince; Ryan M Levy; John Bartels; Arie Baratt; John M Kane; Claudio Lagoa; Jonathan Rubin; Judy Day; Joyce Wei; Mitchell P Fink; Sanna M Goyert; Gilles Clermont; Timothy R Billiar; Yoram Vodovotz Journal: Mol Med Date: 2006 Apr-Jun Impact factor: 6.354
Authors: N Hiki; D Berger; M A Dentener; Y Mimura; W A Buurman; C Prigl; M Seidelmann; E Tsuji; M Kaminishi; H G Beger Journal: Clin Diagn Lab Immunol Date: 1999-11
Authors: Rachael P Jackman; Garth H Utter; Marcus O Muench; John W Heitman; Matthew M Munz; Robert W Jackman; Hope H Biswas; Ryan M Rivers; Leslie H Tobler; Michael P Busch; Philip J Norris Journal: Transfusion Date: 2012-03-27 Impact factor: 3.157
Authors: C Cheval; J F Timsit; M Garrouste-Orgeas; M Assicot; B De Jonghe; B Misset; C Bohuon; J Carlet Journal: Intensive Care Med Date: 2000-03 Impact factor: 17.440
Authors: L C Lemaire; J B van Lanschot; C P Stoutenbeek; S J van Deventer; J Dankert; H Oosting; D J Gouma Journal: Ann Surg Date: 1999-01 Impact factor: 12.969