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Endotoxemia in intensive care patients: A longitudinal study with the limulus amebocyte lysate test

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Summary

In patients with severe underlying disease and in polytraumatized patients, clinical signs of septicemia caused by infections with gram-negative bacteria are observed postoperatively with increasing frequency. Using a photometric LAL test, a longitudinal assessment of LAL reactivity on 41 intensive care patients was performed. Postoperatively, all patients developed a septicemia of different severity with body temperatures >38.5° C. Dividing the individual disease course, related to body temperatures, into three phases (A-C) it was found that independent of the severity of septicemia, the majority of patients (38/41) yielded a positive LAL reactivity. In phase B (body temperature >38.5° C) more plasma samples contained LAL-reactive material than in phase A and C (body temperature <38.5° C). A decline of fever (phase B to C) correlated significantly (P < 0.05) with the change from positive to negative LAL reactivity. In patients with high leukocyte counts (15–50 × 109/l) a positive LAL reactivity was found more frequently. The majority of patients (21/27) who survived were transferred with negative LAL reactivity to the general wards. The results suggest that single determinations of LAL reactivity are of limited clinical validity. Using the individual profile of LAL reactivity gained through a longitudinal assessment, data upon the development of the disease course can be obtained.

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Abbreviations

LAL:

Limulus amebocyte lysate

LPS-E:

Lipopolysaccharide-equivalent

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Authors and Affiliations

  1. Klinische Chemie I im Zentrum Laboratoriumsmedizin der Medizinischen Hochschule Hannover, Germany

    P. C. Fink & J. H. Grunert

  2. Zentralkrankenhaus, Institut für Laboratoriumsmedizin — Zentrallabor, Kliniken der Freien Hansestadt Bremen, St.-Jürgen-Straße, D-2800, Bremen, Bundesrepublik Deutschland

    P. C. Fink

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This work was supported by grant Fi 281/3-3 from the Deutsche Forschungsgemeinschaft

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Fink, P.C., Grunert, J.H. Endotoxemia in intensive care patients: A longitudinal study with the limulus amebocyte lysate test. Klin Wochenschr 62, 986–991 (1984). https://doi.org/10.1007/BF01728429

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  • DOI: https://doi.org/10.1007/BF01728429

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