Endotoxemia and Bacteremia During Hemorrhagic Shock The Link Between Trauma and Sepsis?
Endotoxemia and Bacteremia During Hemorrhagic Shock The Link Between Trauma and Sepsis?
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DOI：
10.1097/00000658-198805000-00009
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发表时间：
1988-05
影响因子：
9
通讯作者：
B. Rush;A. Sori;T. Murphy;Sharon Smith;G. Machiedo
中科院分区：
文献类型：
--
作者：
B. Rush;A. Sori;T. Murphy;Sharon Smith;G. Machiedo
先前对大鼠失血性休克治疗模型的研究表明，细菌血症的频繁发生似乎源于肠道。本文确定了急性休克期间菌血症和内毒素血症的发生率，并将其与不同程度休克的人类类似观察结果进行了比较。对26只大鼠的研究表明，在平均动脉压为30 mmHg时，2小时结束时，分别有50%和87%的大鼠出现菌血症和内毒素血症。对50例入院创伤病房患者的观察显示，入院收缩压为80 mmHg或更低时，56%的患者血细菌培养呈阳性（与其他两组相比p < 0.01）。2例患者出现内毒素血症。在出血性休克或创伤性休克期间，细菌和内毒素可能直接进入血流，在没有其他明显来源的情况下，这是创伤患者随后脓毒症的可能原因。
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 < 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.