INCIDENCE AND PATHOPHYSIOLOGICAL RELEVANCE OF POSTOPERATIVE ENDOTOXEMIA

Patients who underwent surgical procedures usually develop elevated bo dy temperature, changes of plasma levels of some proteins, and leucocy tosis. These alterations are summarized as the postoperative acute-pha se reaction. Also endotoxin can induce the described phenomena suggest ing that endotoxin may play a role concerning the induction of the acu te phase reaction. In order to test that hypothesis we determined endo toxin plasma levels preoperatively and daily postoperatively in patien ts who were operated on because of goiter (n = 20), colonic, pancreati c and gastric diseases (n = 58). A significant increase of endotoxin p lasma levels was found at the first and third day after abdominal surg ery whereas after goiter surgery the increase revealed to be only very slight. However, the decrease between the first and second postoperat ive day in the latter group was again statistically significant sugges ting postoperative endotoxemia even after minor operations. Furthermor e a correlation between the amount of circulating endotoxin and pulmon ary or infectious complications could be established in patients after major operations even at the first postoperative day suggesting a pat hogenetic relevance of postoperative endotoxemia.