DETERMINATION OF ENDOTOXIN-NEUTRALIZING CAPACITY OF PLASMA IN POSTSURGICAL PATIENTS

In 92 patients who underwent abdominal and goiter surgery endotoxin an d endotoxin-neutralizing capacity (ENC) were determined in plasma preo peratively and daily postoperatively. Endotoxin plasma levels started to increase on day 1 in patients who were laparotomized. Corresponding ly ENC was reduced during the 1st postoperative week. Even on the Ist postoperative day determination of ENC made the differentiation betwee n patients possible who showed an uneventful course and patients who d eveloped pneumonia, pulmonary failure, or mental disorders. Furthermor e the need for diuretics in order to maintain sufficient renal functio n was associated with lower ENC during days 1-3. Endotoxin plasma leve ls were significantly elevated in patients who developed pneumonia dur ing days 1-4, whereas the occurrence of pulmonary failure was only cor related with elevated endotoxin levels on day 3. Endotoxemia was prono unced in patients needing diuretics on days 1, 4, and 5. In patients w ho underwent goiter surgery ENC changed significantly as found for end otoxin plasma values during the postoperative course. Determination of endotoxin and especially ENC with the use of the limulus amebocyte ly sate test turned out to be a reliable method correlating with impendin g complications at least in postsurgical patients.