ENDOTOXIN TESTS IN PATIENTS WITH SEPSIS

A new whole blood agglutination assay and a plasma Limulus amoebocyte lysate (LAL) assay for the measurement of endotoxin were evaluated for the diagnosis of sepsis and septic shock in 73 intensive care patient s and 50 normal blood donors, All samples were blinded to the operator s performing the tests. The endotoxin test results were compared with blood culture and clinical observations of sepsis progression. Endotox in was detectable in 34 of 38 patients with culture positive Gram-nega tive bacteraemia, 2 of 11 patients with Gram-positive bacteraemia, 3 o f the 7 patients with suspected sepsis, whose blood culture was repeat edly negative, and 1 of 17 non-septic patients, All blood donors were found to be negative for endotoxin. In 3 patients monitored during the course of their illness, the endotoxin assays correlated closely. We conclude that endotoxin measurement was valuable in the care of patien ts with sepsis and that the whole blood agglutination assay was rapid and simple to perform.