doi: 10.1001/archsurg.1991.01410250012001pmid: N/A
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doi: 10.1001/archsurg.1991.01410250023002pmid: 1985632
Abstract I want to thank the members of the Surgical Infection Society for the trust and honor accorded me through election as President of the Society. The approbation of one's peers truly is the ultimate accolade, and I am grateful both for that boon and for the opportunity to guide the activities of the Surgical Infection Society as it continues to contribute to the body of scientific knowledge and thus to improve the care of our patients. The Society has just completed its first decade. This is an important milestone. It is most appropriate that we meet here in Cincinnati, the home of our founder, William A. Altemeier, MD, and take a look at our accomplishments as well as to try to set an agenda for the future. The Society has successfully completed its infancy and childhood. We are alive and well. We have gained acceptance as a society from our References 1. Altemeier WA. Sepsis in surgery . Arch Surg . 1982;117:107-112.Crossref 2. Pruitt BA Jr. Host-opportunist interactions in surgical infection . Arch Surg . 1986;121:13-22.Crossref 3. Alexander JW. Old problems, new and persistent challenges . Arch Surg . 1987;122:15-20.Crossref 4. Kunin C. The responsibility of the infectious disease community for the optimal use of antimicrobial agents . J Infect Dis . 1985;151:388-389.Crossref 5. Solomkin JS, Dellinger EP, Christou NV, Mason A. Design and conduct of antibiotic trials: a report of the Scientific Studies Committee of the Surgical Infection Society . Arch Surg . 1987;122:158-164.Crossref 6. Bricker EM. Industrial marketing and medical ethics . N Engl J Med . 1989;320:1690-1692.Crossref 7. Diamond AL, Robinson K. Payments to doctors and the responsibilities of ethics committees . BMJ . 1984;288:322-323.Crossref 8. Condon RE, Haley RW, Lee JT Jr, Meakins JL. Does infection control control infection? Arch Surg . 1988;123:250-256.Crossref 9. Cruse PJE, Foord R. The epidemiology of wound infection: a 10-year prospective study of 62,939 wounds . Surg Clin North Am . 1980;60:27-40. 10. Condon RE, Schulte WJ, Malangoni MA, Anderson-Teschendorf MJ. Effectiveness of a surgical wound surveillance program . Arch Surg . 1983;118:303-307.Crossref 11. Haley RW, Culver DH, White JW, et al. The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals . Am J Epidemiol . 1985;121:182-205. 12. Meade PD, Pries SE, Hall P. Decreasing the incidence of surgery wound infections: validation of a surveillance-notification program . Arch Surg . 1986;121:458-461.Crossref 13. Olson MM, Lee JT Jr. Continuous, ten-year wound infection surveillance: results, advantages and unanswered questions . Arch Surg . 1990;125:794-803.Crossref 14. Scheckler WE. Surgeon-specific wound infection rates: a potentially dangerous and misleading strategy . Infect Control . 1988;9:145-146. 15. Bryan JS. Surgeon-specific wound surveillance: the family or the bean counters? Infect Control . 1989;10:376-378. 16. Haley RW, Morgan WM, Culver DH, et al. Hospital infection control: recent progress and opportunities under prospective payment . Am J Infect Control . 1985;13:97-108.Crossref 17. Platt R. Perioperative antibiotic prophylaxis for herniorrhaphy and breast surgery . N Engl J Med . 1990;322:153-160.Crossref 18. Condon RE. Aids and the surgeon. Presented at the Surgical Infection Society Meeting; May 6, 1988; San Francisco, Calif. 19. Centers for Disease Control . HIV/AIDS Surveillance Report . 1990;13. 20. Centers for Disease Control. Estimates of HIV prevalence and projected AIDS cases . MMWR . 1990;39:110-119. 21. McKinney WP, Young MJ. The cumulative probability of occupationally-acquired HIV infection: the risks of repeated exposures during a surgical career . Infect Control . 1990;11:243-247. 22. Quebbeman EJ, Telford GL, Condon RE. Dealing with the threat of AIDS in the operating room environment . Perspect Vase Surg . 1989;2:121-137.Crossref
Austgen, Thomas R.;Chen, Mike K.;Moore, Wendy;Souba, Wiley W.
doi: 10.1001/archsurg.1991.01410250027003pmid: 1670757
Abstract • The effect of endotoxin on renal glutamine metabolism and ammoniagenesis was investigated in vivo in the rat to gain further insight into the altered glutamine flow that characterizes critical illness. Studies were done 15 hours following a single dose of Escherichia coli lipopolysaccharide (10 mg/kg). Renal blood flow and arterial glutamine concentration were similar in control and study rats, but the kidney switched from an organ of slight glutamine uptake in controls (129 ± 52 nmol/100 g of body weight per minute) to net release in the endotoxin-treated animals ( −273 ± 170 nmol/100 g of body weight per minute). Simultaneously, the specific activity of renal glutamine synthetase increased by almost 50% (374 ± 40 nmol/mg of protein per hour in rats given endotoxin vs 253 ± 12 nmol/mg of protein per hour in controls), while glutaminase was unchanged. Urinary ammonia excretion was reduced by 35% in the endotoxin-treated animals (47±6 μmol/12 h in endotoxin-treated animals vs 70±8 μmol/12 h in controls) despite a 10% fall in the arterial bicarbonate value. Endotoxin alters the net flux of glutamine across the kidney which appears to be partially regulated enzymatically. This may impair the kidneys' ability to maintain acid/base homeostasis. (Arch Surg. 1991;126:23-27) References 1. Souba WW, Wilmore DW. Diet and nutrition in the care of the patient with surgery, trauma, and sepsis . In: Shils M, Young V, eds. Modern Nutrition in Health and Disease . 7th ed. Philadelphia, Pa: Lea and Febiger; 1988:1306-1336. 2. Michie HR, Manogue KR, Spriggs DR. Detection of circulating tumor necrosis factor after endotoxin administration . N Engl J Med . 1988;318:1481-1486.Crossref 3. Parry-Billings M, Leighton B, Dimitriadis G, de Vasconcelos PRL, Newsholme EA. Skeletal muscle glutamine metabolism during sepsis in the rat . Int J Biochem . 1989;21:419-423.Crossref 4. Bergstrom dJ, Furst P, Noree LO, Vinnars E. Intracellular free amino acid concentration in human muscle tissue . J Appl Physiol . 1974;36:693-699. 5. Pitts RF. The renal excretion of acid . Fed Proc . 1948;7:418-426. 6. Pitts RF, Pilkington LA, De Hass JCM. N 15 tracer studies on the origin of urinary ammonia in the acidotic dog . J Clin Invest . 1965;44:731-735.Crossref 7. Welbourne TC, Phromphetcharat V. Renal glutamine metabolism and hydrogen ion homeostasis . In: Haussinger D, Sies H, eds. Glutamine Metabolism in Mammalian Tissues . New York, NY: Springer-Verlag NY Inc. 1984:161-177. 8. Welbourne TC, Phromphetcharat V, Givens G, Joshi S. Regulation of interorganal glutamine flow in metabolic acidosis . Am J Physiol . 1986;250:E457-E463. 9. Phromphetcharat V, Jackson A, Dass PD, Welbourne TC. Ammonia partitioning between glutamine and urea: interorgan participation in metabolic acidosis . Kidney Int . 1981;20:598-605.Crossref 10. Souba WW. Interorgan ammonia metabolism in health and disease: a surgeons view . JPEN J Parenter Enteral Nutr . 1987;11:569-579.Crossref 11. Frisell WR. Synthesis and catabolism of nucleotides . In Frisell WR, ed. Human Biochemistry . New York, NY: Macmillan Publishing Co Inc; 1982: 292-304. 12. MacLennan PA, Brown RA, Rennie MJ. A positive relationship between protein synthetic rate and intracellular glutamine concentration in perfused rat skeletal muscle . FEBS Lett . 1987;215:187-191.Crossref 13. Millward DJ, Jepson MM, Omer A. Muscle glutamine concentration and protein turnover in malnutrition and in endotoxemia . Metabolism . 1989; 38:6-13.Crossref 14. Rennie MJ, MacLennan PA, Hundal HS, et al. Skeletal muscle glutamine transport, intramuscular glutamine concentration, and muscle protein turnover . Metabolism . 1989;38:47-51.Crossref 15. Mandel LJ. Metabolic substrates, cellular energy production, and the regulation of proximal tubular transport . Ann Rev Physiol . 1985;47:85-101.Crossref 16. Windmueller HG. Glutamine utilization by the small intestine . Adv Enzymol . 1982;53:201-237. 17. Souba WW, Scott TE, Wilmore DW. Intestinal consumption of intravenously administered fuels . JPEN J Parenter Enteral Nutr . 1985;9:18-22.Crossref 18. Newsholme EA, Newsholme P, Curi R, Challoner E, Ardawi MSM. A role for muscle in the immune system and its importance in surgery, trauma, sepsis, and burns . Nutrition . 1988;4:261-268. 19. Zeilke RH, Ozand PT, Tilden JT, Sevdalian DA, Cornblath M. Reciprocal regulation of glucose and glutamine utilization by cultured human diploid fibroblasts . J Cell Physiol . 1978;95:41-46.Crossref 20. Welbourne TC, Childress D, Givens G. Renal regulation of interorgan glutamine flow in metabolic acidosis . Am J Physiol . 1986;251:R858-R866. 21. Lemieux G, Baverel G, Vinay P, Wadoux P. Glutamine synthetase and glutamyltransferase in the kidney of man, dog, and rat . Am J Physiol . 1976;231:1068-1073. 22. Damian AC, Pitts RF. Rates of glutaminase I and glutamine synthetase reactions in rat kidney in vivo . Am J Physiol . 1970;218:1249-1255. 23. Shapiro RA, Banner C, Hwang JJ, Wenthold RJ, Curthoys NP. Regulation of renal glutaminase gene expression during metabolic acidosis . Contrib Nephrol . 1988;63:141-146. 24. Bergmeyer HU, ed. Methods of Enzymatic Analysis . New York, NY: John Wiley & Sons Inc; 1974;4:1704-1708. 25. Conway EJ. Microdiffusion Analysis and Volumetric Effort . London, England: G Rosvy Publishers; 1950. 26. Lowry OH, Rosenbrough WJ, Farr AL, Randall RJ. Protein measurement with folin phenol reagent . J Biol Chem . 1951;193:265-276. 27. Pinkus LM, Windmueller HG. Phosphate-dependent glutaminase of small intestine: localization and role in glutamine metabolism . Arch Biochem Biophys . 1977;182:506-517.Crossref 28. Welbourne TC. Effect of metabolic acidosis on hindquarter glutamine and alanine release . Metabolism . 1986;35:614-618.Crossref 29. Squires EJ, Hall DE, Brosnan JT. Arteriovenous differences for amino acids and lactate across kidneys of normal and acidotic rats . Biochem J . 1976;160:125-128. 30. Churchill PC, Bidani AK, Schwartz MM. Renal effects of endotoxin in the male rat . Am J Physiol . 1987;253:F244-F250. 31. Kikeri D, Pennell JP, Hwang KH, Jacobs AI, Richman AV, Bourgoigne JJ. Endotoxemic acute renal failure in awake rats . Am J Physiol . 1986;250:F1098-F1106. 32. Wang J, Dunn M. Platelet-activating factor mediates endotoxin-induced acute renal insufficiency in rats . Am J Physiol . 1987;253:F1283-F1289. 33. Raghu G, Striker LJ, Striker GE. Lipopolysaccharide-mediated injury to cultured human glomerular endothelial cell . Clin Immunol Immunopathol . 1986;38:275-281.Crossref 34. Richman AV, Okulski EG, Balis JU. New concepts in the pathogenesis of acute tubular necrosis associated with sepsis . Ann Clin Lab Sci . 1981;11:211-219. 35. Wardle N. Acute renal failure in the 1980s: the importance of septic shock and of endotoxemia . Nephron . 1982;30:193-200.Crossref 36. Schoendorf TH, Rosenberg M, Beller FK. Endotoxin induced disseminated intravascular coagulation in nonpregnant rats . Am J Pathol . 1971;65:51-58. 37. Welbourne TC, Bazer GT. Mitochondrial glutamine permeability and renal ammonia production in metabolic acidosis . Am J Physiol . 1980;239:E51-E56. 38. Windus DW, Cohn DE, Klahr S, Hammerman MC. Glutamine transport in renal basolateral vesicles from dogs with metabolic acidosis . Am J Physiol . 1984;256:F1027-F1033. 39. Welbourne TC. Hormonal and Na effect on renal glutamine uptake . Am J Physiol . 1989;256:F1027-F1033. 40. English LH, Cantley LC. Delta endotoxin is a potent inhibitor of the (Na, K)-ATPase . J Biol Chem . 1986;261:1170-1173. 41. Burch HB, Chan AWK, Alvey TR, Lowry OH. Localization of glutamine accumulation and tubular reabsorption in rat nephron . Kidney Int . 1978;14:406-413.Crossref 42. Nonoguchi H, Uchida S, Shiigai T, Endou H. Effect of chronic metabolic acidosis on ammonia production from L-glutamine in microdissected rat nephron segments . Pflugers Arch . 1985;403:229-235.Crossref
Callery, Mark P.;Kamei, Takafumi;Mangino, Martin J.;Flye, M. Wayne
doi: 10.1001/archsurg.1991.01410250032004pmid: 1985633
Abstract • Endotoxin (lipopolysaccharide [LPS]) and tumor necrosis factor (TNF-α) have been implicated in the pathogenesis of sepsis-induced adult respiratory distress syndrome. To evaluate the possible interaction of the hepatic-pulmonary macrophage axis in the adult respiratory distress syndrome, we compared the kinetics of immunosuppressive prostaglandin E2, TNF-α, and interleukin 6 production in LPS-stimulated Kupffer cells and alveolar macrophages (AMs). Interleukin 6 production by Kupffer cells was significantly higher than for equal numbers of AMs. Kupffer cell TNF-α levels peaked early before decreasing as regulatory prostaglandin E2 levels rose. In contrast, AM TNF-α levels rose sharply and remained significantly higher than for Kupffer cells throughout culture coincident with negligible prostaglandin E2 production. Kupffer cell sequestration of LPS may normally invoke a coordinated cytokine response able to locally induce acute-phase hepatocytes. In hepatic failure, however, LPS spillover to the lung may promote adult respiratory distress syndrome by inducing unregulated AM TNF-α production within the pulmonary microenvironment. (Arch Surg. 1991;126:28-32) References 1. Montgomery AB, Stager MA, Carrico CJ, et al. Causes of mortality in patients with the adult respiratory distress syndrome . Am Rev Respir Dis . 1985;132:485-489. 2. Fein AM, Lippmann M, Holtzmann H, et al. The risk factors, incidence and prognosis of ARDS following septicemia . Chest . 1983;83:40-42.Crossref 3. Bell RC, Coalson JJ, Smith JD, Johanson WG Jr. Multiple organ system failure and infection in adult respiratory distress syndrome . Ann Intern Med . 1983;99:293-298.Crossref 4. Carrico CJ, Meakins JL, Marshall JC, Fry D, Maier RV. Multiple-organ-failure syndrome . Arch Surg . 1986;121:196-208.Crossref 5. Matuschak GM, Rinaldo JE, Pinsky MR, Gavaler JS, Van Thiel DH. Effect of end-stage liver failure on the incidence and resolution of the adult respiratory distress syndrome . J Crit Care . 1987;2:162-173.Crossref 6. Matuschak GM, Rinaldo JE. Organ interactions in the adult respiratory distress syndrome during sepsis . Chest . 1988;94:400-406.Crossref 7. Beutler B, Cerami A. Tumor necrosis, cachexia, shock, and inflammation: a common mediator . Annu Rev Biochem . 1988;57:505-518.Crossref 8. Tracey KJ, Lowry SF. The role of cytokine mediators in septic shock . Adv Surg . 1990;23:21-56. 9. Tracey KJ, Lowry SF, Cerami A. Cachectin/TNF-α in septic shock and septic adult respiratory distress syndrome . Am Rev Respir Dis . 1988;138:1377-1379.Crossref 10. Stephens KE, Ishizaka A, Larrick JW, Raffin TA. Tumor necrosis factor causes increased pulmonary permeability and edema . Am Rev Respir Dis . 1988;137:1364-1370.Crossref 11. Tracey KJ, Beutler B, Lowry SF, et al. Shock and tissue injury induced by recombinant human cachectin . Science . 1986;234:470-474.Crossref 12. Tracey KJ, Lowry SF, Fahey TJ III, et al. Cachectin/tumor necrosis factor induces lethal shock and stress hormone responses in the dog . Surg Gynecol Obstet . 1987;164:415-422. 13. Ferrari-Baliviera E, Mealy K, Smith RJ, Wilmore DW. Tumor necrosis factor induces adult respiratory distress syndrome in rats . Arch Surg . 1989;124:1400-1405.Crossref 14. Millar AB, Singer M, Meagher A, Foley NM, Johnson N McI, Rook GAW. Tumour necrosis factor in bronchopulmonary secretions of patients with adult respiratory distress syndrome . Lancet . 1989;2:712-714.Crossref 15. Marinkovic S, Jahreis GP, Wong GG, Baumann H. IL-6 modulates the synthesis of a specific set of acute phase plasma proteins in vivo . J Immunol . 1989;142:808-812. 16. Goodwin JS, Webb DR. Regulation of the immune response by prostaglandins . Clin Immunol Immunopathol . 1980;15:106-122.Crossref 17. Decker T, Lohmann-Matthes ML, Karck U, Peters T, Decker K. Comparative study of cytotoxicity, tumor necrosis factor, and prostaglandin release after stimulation of rat Kupffer cells, murine Kupffer cells, and murine inflammatory macrophages . J Leukoc Biol . 1989;45:139-146. 18. Callery MP, Mangino MJ, Kamei T, Flye MW. Interleukin-6 production by endotoxin-stimulated Kupffer cells is regulated by prostaglandin-E2 . J Surg Res . 1990;48:523-527.Crossref 19. Mangino MJ, Brunt EM, VonDoersen P, Anderson CB. Effects of the thromboxane synthesis inhibitor CGS-12970 on experimental acute renal allograft rejection . J Pharmacol Exp Ther . 1989;248:23-28. 20. Parker MM, Parillo JE. Septic shock: hemodynamics and pathogenesis . JAMA . 1983;250:3324-3327.Crossref 21. Elin RJ, Wolff SM. Biology of endotoxin . Annu Rev Med . 1976;27: 127-141.Crossref 22. Demling RH. The cardiopulmonary effects of sepsis on the trauma patient . Crit Care Clin . 1986;2:853-867. 23. Jacobs ER, Bone RC. Clinical indicators in sepsis and septic adult respiratory distress syndrome . Med Clin North Am . 1986;70:921-932. 24. Dinarello CA, Mier JW. Current concepts: lymphokines . N Engl J Med . 1987;317:940-945.Crossref 25. Michie HR, Wilmore DW. Sepsis, signals, and surgical sequelae (a hypothesis) . Arch Surg . 1990;125:531-536.Crossref 26. Beutler BA, Milsark IW, Cerami A. Cachectin/tumor necrosis factor: production, distribution, and metabolic fate in vivo . J Immunol . 1985;135:3972-3977. 27. Michie HR, Manogue KR, Spriggs DR, et al. Detection of circulating tumor necrosis factor after endotoxin administration . N Engl J Med . 1988;318:1481-1486.Crossref 28. Tracey KJ, Fong Y, Hesse DG, et al. Anti-cachectin/TNF monoclonal antibodies prevent septic shock during lethal bacteraemia . Nature . 1987;330:662-664.Crossref 29. Beutler B, Milsark IW, Cerami AC. Passive immunization against cachectin/tumor necrosis factor protects mice from lethal effect of endotoxin . Science . 1985;229:869-871.Crossref 30. Saba TM. Physiology and pathophysiology of the reticuloendothelial system . Arch Intern Med . 1970;126:1031-1052.Crossref 31. Perlmutter DH, Dinarello CA, Punsal PI, Colten HR. Cachectin tumor necrosis factor regulates hepatic acute phase gene expression . J Clin Invest . 1986;78:1349-1354.Crossref 32. Cornell RP. Gut-derived endotoxin elicits hepatotrophic factor secretion for liver regeneration . Am J Physiol . 1985;249:R551-R562. 33. Callery MP, Kamei T, Mangino MJ, Flye MW. Endotoxin stimulates Interleukin-6 production by rat Kupffer cells . J Leukoc Biol . 1989;46:300. Abstract. 34. Callery MP, Kamei T, Flye MW. Kupffer cell blockade increases mortality during intra-abdominal sepsis despite improving systemic immunity . Arch Surg . 1990;125:36-41.Crossref 35. Nelson S, Bagby GJ, Bainton BG, Wilson LA, Thompson JJ, Summer WR. Compartmentalization of intraalveolar and systemic lipopolysaccharide-induced tumor necrosis factor and the pulmonary inflammatory response . J Infect Dis . 1989;159:189-194.Crossref 36. Callery MP, Kamei T, Mangino MJ, et al. Organ interactions in sepsis: host defense and the hepatic-pulmonary macrophage axis . Arch Surg . 1991;126:28-32.Crossref 37. Tracey KJ, Lawry SF. The role of cytokine mediators in septic shock . Adv Surg . 1990;23:21-56.
Mainous, Mark R.;Tso, Patrick;Berg, Rodney D.;Deitch, Edwin A.
doi: 10.1001/archsurg.1991.01410250037005pmid: 1824677
Abstract • Bacteria have been documented to translocate from the gut to systemic organs, yet the exact route by which they translocate remains unclear. To determine the route of bacterial translocation, different dosages of zymosan were used to activate complement and cause systemic inflammation. At a zymosan dose of 0.1 mg/g, bacteria translocated only to the mesenteric lymph node complex, whereas at a dose of 0.5 mg/g the bacteria translocated systematically. In rats receiving 0.5-mg/g doses of zymosan, the bacteria appeared to reach systemic organs via the portal blood rather than via the mesenteric lymph, as bacteria were present in 87% of portal blood samples but only 25% of lymph samples. The number of bacteria exiting the portal vein was 11 500 times greater than the number exiting via the lymph. Thus, both the route and extent of bacterial translocation varies based on the magnitude of the inflammatory insult, with the portal blood being the major route of bacterial translocation to systemic organs. (Arch Surg. 1991;126:33-37) References 1. Berg RD, Garlington AW. Translocation of certain indigenous bacteria from the gastrointestinal tract to the mesenteric lymph node and other organs in a gnotobiotic mouse model . Infect Immun . 1979;23:403-411. 2. Maejima K, Deitch EA, Berg RD. Promotion by burn stress of the translocation of bacteria from the gastrointestinal tracts of mice . Arch Surg . 1984;119:166-172.Crossref 3. Baker JW, Deitch EA, Li M, Berg RD, Specian RD. Hemorrhagic shock induces bacterial translocation from the gut . J Trauma . 1988;28:896-906.Crossref 4. Morehouse JL, Specian RD, Stewart JJ, Berg RD. Promotion of translocation of indigenous bacteria from the gastrointestinal tract of mice by oral ricinoleic acid . Gastroenterology . 1986;91:673-682. 5. Alverdy JC, Aoys E, Moss GS. Total parenteral nutrition promotes bacterial translocation from the gut . Surgery . 1988;104:185-190. 6. Deitch EA, Berg RD, Specian RD. Endotoxin promotes the translocation of bacteria from the gut . Arch Surg . 1987;122:185-190.Crossref 7. Deitch EA, Winterton J, Berg RD. Deficiency of T-cell mediated immunity promotes bacterial translocation from the gastrointestinal tract after thermal injury . Arch Surg . 1986;121:97-101.Crossref 8. Berg RD. Bacterial translocation from the gastrointestinal tracts of mice receiving immunosuppressive chemotherapeutic agents . Curr Microbiol . 1983;8:285-292.Crossref 9. Deitch EA, Maejima K, Berg RD. Effect of oral antibiotics and bacterial overgrowth on the translocation of the gastrointestinal tract microflora in burned rats . J Trauma . 1985;25:385-392.Crossref 10. Bodey GP. Antibiotic prophylaxis in cancer patients: regimens of oral, nonabsorbable antibiotics for prevention of infection during induction of remission . Rev Infect Dis . 1981;3:S259-S268.Crossref 11. Jarrett F, Balish L, Moylan JA, Ellerbe S. Clinical experience with prophylactic bowel suppression in burn patients . Surgery . 1978;83:523-527. 12. Woodruff RW, O'Carroll DE, Koizumic S, Fine J. Role of the intestinal flora in major trauma . J Infect Dis . 1973;128:S290-S294.Crossref 13. Border JR, Hassett J, LaDuca J, et al. The gut origin septic states in blunt multiple trauma (ISS = 40) in the ICU . Ann Surg . 1987;206:427-448.Crossref 14. Goris RJA, Boekhorst TPA, Nuytinck JKS, Gimbrere JSF. Multiple organ failure: generalized autodestructive inflammation? Arch Surg . 1985;120:1109-1115.Crossref 15. Nuytinck JKS, Goris RJA, Redl H, Schlag G, vanMunster PJJ. Posttraumatic complications and inflammatory mediators . Arch Surg . 1986; 121:886-890.Crossref 16. Goris RJA, Boekholtz WKF, vanBebber IPT, Nuytinck JKS, Schillings PHM. Multiple organ failure and sepsis without bacteria. Arch Surg . 1986;121:897-901.Crossref 17. Schirmer WJ, Schirmer JM, Naff GB, Fry DE. Systemic complement activation produces hemodynamic changes characteristic of sepsis . Arch Surg . 1988;123:316-321.Crossref 18. Czop JK. Phagocytosis of particulate activators of the alternative complement pathway . Adv Immunol . 1986;38:361-398. 19. Lindema J, Burkhardt H, Dwenger A. Mechanisms of non-opsonized zymosan-induced and luminol-enhanced chemiluminescence in whole blood and isolated phagocytes . J Clin Chem Clin Biochem . 1987;25:765-778. 20. Schirmer WJ, Schirmer JM, Naff GB, Fry DE. Visceral perfusion abnormalities following complement activation . Am Surg . 1988;54:687-692. 21. Granger DN. Intestinal microcirculation and transmucosal fluid transport . Am J Physiol . 1981;240:G343-G349. 22. Wells CL, Maddaus MA, Erlandsen SL, Simmons RL. Evidence for the phagocytic transport of intestinal particles in dogs and rats . Infect Immun . 1988;56:278-282. 23. Wells CL, Maddaus MA, Simmons RL. Role of the macrophage in the translocation of intestinal bacteria . Arch Surg . 1987;122:48-53.Crossref 24. Wells CL, Maddaus MA, Simmons RL. Proposed mechanisms for the translocation of intestinal bacteria . Rev Infect Dis . 1988;10:958-979.Crossref 25. Schirmer WJ, Schirmer JM, Naff GB, Fry DE. Alternative pathway complement activation induces reductions in effective hepatic blood flow . Curr Surg . 1987;44:304-307. 26. Schenck GW Jr, McDonald JC, McDonald K, Drapanas T. Direct measurement of hepatic blood flow in surgical patients with related observations on hepatic flow dynamics in experimental animals . Ann Surg . 1962;156:463-471.Crossref 27. Reynolds TB, Redeker AG. Hepatic hemodynamics and portal hypertension . Prog Liver Dis . 1965;2:457-473. 28. Dencker H, Kamme C, Norryd C, Mardh P-A, Tylen U. Examination for aerobic and anaerobic bacteria in human portal blood collected by transumbilical catheterization . Scand J Gastroenterol . 1974;9:367-369. 29. Taylor FN. Blood culture studies of the portal vein . Arch Surg . 1956;72:889-892.Crossref 30. Orloff MJ, Peskin GW, Ellis HL. A bacteriologic study of human portal blood . Ann Surg . 1958;148:738-746.Crossref 31. Jacob AI, Goldberg PK, Bloom N, Degenshein GA, Kozinn PJ. Endotoxin and bacteria in portal blood . Gastroenterology . 1977;72:1268-1270. 32. Coblentz A, Kelly KH, Fitzpatrick L, Bierman HR. Microbiologic studies of the portal and hepatic venous blood in man . Am J Med Sci . 1954;228:298-300.Crossref 33. Triger DR, Boyer TD, Levin J. Portal and systemic bacteremia and endotoxemia in liver disease . Gut . 1978;19:935-939.Crossref 34. McCuskey RS, McCuskey PA, Urbaschek R, Urbaschek B. Kupffer cell function in host defense . Rev Infect Dis . 1987;9( (suppl 15) ):S616-S619.Crossref 35. Holper K, Olcay I, Kitahama A, et al. Effect of ischemia on hepatic parenchymal and reticuloendothelial function in the baboon . Surgery . 1974;76:423-432. 36. Dieter P, Altin JG, Bygrave FL. Possible involvement of prostaglandins in vasoconstriction induced by zymosan and arachidonic acid in the perfused rat liver . FEBS Lett . 1987;213:174-178.Crossref 37. Machiedo GW, Hurd T, Rush BF Jr, Dikdan G, McGee J, Lysz T. Temporal relationship of hepatocellular dysfunction and ischemia in sepsis . Arch Surg . 1988;123:424-427.Crossref 38. Townsend MC, Hampton WW, Haybron DM, Schirmer WJ, Fry DE. Effective organ blood flow and bioenergy status in murine peritonitis . Surgery . 1986;100:205-212. 39. Hampton WW, Townsend MC, Haybron DM, Schirmer WJ, Fry DE. Effective hepatic blood flow and hepatic bioenergy status in murine peritonitis . J Surg Res . 1987;42:33-38.Crossref 40. Sato T, Tanika J, Kono Y, Jones RT, Crowley A, Trump BF. Hepatic cellular injury following lethal Escherichia coli bacteremia in rats . Lab Invest . 1982;47:304-310. 41. Asher EF, Rowe RL, Garrison RN, Fry DE. Experimental bacteremia and hepatic nutrient blood flow . Circ Shock . 1986;20:43-49.
Gore, Dennis C.;Honeycutt, Darcy;Jahoor, Farook;Wolfe, Robert R.;Herndon, David N.
doi: 10.1001/archsurg.1991.01410250042006pmid: 1898697
Abstract • The effect of growth hormone on protein kinetics was assessed in burned patients during the hyperdynamic phase using N15 lysine and balance data across the leg. Levels of resting energy expenditure and cardiac index were comparably elevated in all patients, but leg blood flow was greater in the patients receiving growth hormone. Growth hormone therapy (0.2 mg/kg per day) significantly stimulated protein synthesis in the whole body and in the studied leg. A hyperinsulinemic clamp, which raised the insulin concentration to more than 1435 pmol/L of blood, caused comparable stimulation of leg protein synthesis in patients not receiving growth hormone, but did not further increase protein synthesis in the growth hormone–treated patients. These results suggest that administration of exogenous growth hormone may limit the peripheral protein wasting in severely injured patients by a mechanism similar to that of insulin. (Arch Surg. 1990;126:38-43) References 1. Wolfe RR. Nutrition and Metabolism in Burns . In: Critical Care . Fullerton, Calif: Society of Critical Care Medicine; 1986;7:19-23. 2. Herndon DN, Curreri RW, Abston S, Rutan RC, Barrow RE. Treatment of burns. Curr Probi Surg . 1987;2:347-373.Crossref 3. Wilmore DW, Moylan JA, Bristow BF, Mason AD, Pruitt BA. Anabolic effects of human growth hormone and high caloric feedings following thermal injury . Surg Gynecol Obstet . 1974;138:875-884. 4. Jiang ZM, He GZ, Zhang SY, et al. Low-dose growth hormone and hypocaloric nutrition attenuate the protein-catabolic response after major operation . Ann Surg . 1989;210:513-525.Crossref 5. Hildreth MA, Herndon DN, Parks DH, Desai NH, Rutan T. Evaluation of a caloric requirement formula in burned children treated with early excision . J Trauma . 1987;27:188-189.Crossref 6. Rosenblatt JI, Wolfe RR. Calculation of substrate flux using stable isotopes . Am J Physiol . 1988;254:E526-E531. 7. Waterlow JC, Garlick PJ, Millward DJ. The effects of nutrition and hormones on protein turnover in muscle . In: Protein Turnover in Mammalian Tissues and in Whole Body . Amsterdam, the Netherlands: Elsevier North-Holland Publishers; 1978:625-696. 8. Goldberg AL, Chang TW. Regulation and significance of amino acid metabolism in skeletal muscle . Fed Proc . 1978;37:2301-2307. 9. Cheng KN, Pacy PJ, Dwarzak F, Ford GC, Halliday D. Influence of fasting on leucine and muscle protein metabolism across the human forearm determined using L(113C, 15N) leucine as the tracer . Clin Sci . 1987;73:241-246. 10. Harris JA, Benedict FG. A Biometric Study of Basal Metabolism in Man . Washington, DC: Carnegie Institute of Washington; 1919. Publication 279. 11. Wilmore DW, Aulick LH, Mason AD, Pruitt BA. Influence of the burn wound on local and systemic responses to injury . Ann Surg . 1977;186:444-458.Crossref 12. Herndon DN, Barrow RE, Kunkel KR, Rutan RL. Effects of recombinant human growth hormone on donor site healing in severely burned children . Ann Surg . 1990;212:424-431.Crossref 13. Ponting GA, Teale JD, Halliday D, Sim AJW. Postoperative positive nitrogen balance with intravenous hyponutrition and growth hormone . Lancet . 1988:438-439. 14. Wolfe RR, Goodenough RD, Burke JF, Wolfe MH. Response of protein and urea kinetics in burn patients to different levels of protein intake. Ann Surg . 1983;197:163-171.Crossref 15. Gelfand RA, Barrett EJ. Effect of physiologic hyperinsulinemia on skeletal muscle proteins synthesis and breakdown in man . J Clin Invest . 1987;80:1-6.Crossref 16. Fukagawa NK, Minaker KL, Rowe JW, et al. Insulin mediated reduction of whole-body protein breakdown: dose response effects of leucine metabolism in postabsorptive men . J Clin Invest . 1985;76:2306-2311.Crossref 17. Jefferson LS, Li JB, Rannels SR. Regulation by insulin of amino acid and protein turnover in the perfused rat hemicorpus . J Biol Chem . 1977;252:1476-1483. 18. Frayn KN, Maycock PF. Regulation of protein metabolism by a physiological concentration of insulin in mouse soleus and extensor digitorium longus muscles . Biochem J . 1979;1984:323-330. 19. Lundholm K, Edstrom S, Ekman L, Karberg I, Walker P, Scherstein T. Protein degradation in human skeletal muscle tissue: the effect of insulin, leucine, amino acids and ions . Clin Sci . 1981;60:319-326. 20. Stirewalt WS, Low RB, Slaiby JM. Insulin sensitivity and responsiveness of epitrochlearis and soleus muscle from fed and starved rats . Biochem J . 1985;227:355-362. 21. Belcher HNCR, Mercer D, Jukins KC, et al. Biosynthetic human growth hormone in burned patients: a pilot study . Burns . 1989;15:99-107.Crossref 22. Shangraw RE, Jahoor F, Miyoshi H, et al. Differentiation between septic and postburn insulin resistance . Metabolism . 1989;30:983-989.Crossref 23. Jahoor F, Shangraw RE, Miyoshi H, Wallfish H, Herndon DN, Wolfe RR. Role of insulin and glucose oxidation in mediating the protein catabolism of burns and sepsis. Am J Physiol . 1989;256:E323-E331. 24. Manson JM, Wilmore DW. Positive nitrogen balance with human growth hormone and hypocaloric intravenous feeding . Surgery . 1986;100:188-197. 25. Fukagawa NK, Minaker KL, Good WR, et al. Acute effects of insulin-like growth factor I (IgF-1) on leucine kinetics in healthy men . Diabetes . 1990:3A. Abstract.
doi: 10.1001/archsurg.1991.01410250047007pmid: N/A
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract In the discussion on page 1315 of the October 1990 issue of the ARCHIVES, the remarks under the name of C. James Carrico, MD (second entry) should have been listed in the discussion of the article that follows. This error was graciously called to our attention by the editor of Surgery, Walter F. Ballinger, MD, who carefully reads the Archives.—The Editor
Becker, William K.;Cioffi, William G.;McManus, Albert T.;Kim, Seung H.;McManus, William F.;Mason, Arthur D.;Pruitt, Basil A.
doi: 10.1001/archsurg.1991.01410250048008pmid: 1985634
Abstract • To evaluate our experience with fungal burn wound infection, we performed a 10-year review for comparison with our experience with bacterial burn wound infection. During the study period, a marked decline occurred in bacterial wound infection but not in fungal wound infection. Patients with either bacterial or fungal burn wound infection had massive injury, with burn size averaging greater than 50% of the total body surface area. Factors that appear to have markedly reduced bacterial burn wound infection, including patient isolation, topical chemotherapeutic agents, and burn wound excision, do not appear to have had a similar effect on fungal wound infection. The mechanism of spread and colonization of fungi, and the lack of effective topical chemotherapeutic antifungal agents, may explain in part our findings. (Arch Surg. 1991;126:44-48) References 1. Moncrief JA, Lindberg RB, Switzer WE, Pruitt BA Jr. Use of topical antibacterial therapy in the treatment of the burn wound . Arch Surg . 1966;92:558-565.Crossref 2. Nash G, Foley FD, Goodwin MN Jr, Bruck HM, Greenwald KA, Pruitt BA Jr. Fungal burn wound infection . JAMA . 1971;215:1664-1666.Crossref 3. Cervia JS, Murray HW. Fungal cholecystitis and AIDS . J Infect Dis . 1990;161:358.Crossref 4. Merrell SW, Shelby J, Freeman TR, Saffle JR. Effect of exchange transfusion on cell-mediated immune function following thermal injury . J Trauma . 1988;28:184-189.Crossref 5. Taber WA. Classification of fungi . In: Braude AI, ed. Medical Microbiology and Infectious Diseases . Philadelphia, Pa: WB Saunders Co; 1981:147-156. 6. Kim SH, Hubbard GB, Worley GB, McManus WF, Mason AD Jr, Pruitt BA Jr. A rapid section technique for burn wound biopsy . J Burn Care Rehabil . 1985;6:433-435.Crossref 7. Kim SH, Hubbard GB, McManus WF, Mason AD Jr, Pruitt BA Jr. Frozen section technique to evaluate early burn wound biopsy: a comparison with the rapid section technique . J Trauma . 1985;25:1134-1337.Crossref 8. McManus WF, Goodwin CW Jr, Pruitt BA Jr. Subeschar treatment of burn-wound infection . Arch Surg . 1983;118:291-294.Crossref 9. Spebar MJ, Walters MJ, Pruitt BA Jr. Improved survival with aggressive surgical management of noncandidal fungal infections of the burn wound . J Trauma . 1982;22:867-868.Crossref 10. Aldrich RH. The role of infection in burns: the theory and treatment with special reference to gentian violet . N Engl J Med . 1933;208:299-309.Crossref 11. Pruitt BA Jr. Phycomycotic infections . Prob Gen Surg . 1984;1:664-678. 12. Foley FD, Shuck JM. Burn-wound infection with phycomycetes requiring amputation of the hand . JAMA . 1968;203:596.Crossref 13. Stone HH, Cuzzell JZ, Kolb LD, Moskowitz MS, McGowan JE. Aspergillus infection of the burn wound . J Trauma . 1979;19:765-767.Crossref 14. McManus AT. Pseudomonas aeruginosa: a controlled burn pathogen? Antibiot Chemother . 1989;42:103-108. 15. Gartenberg G, Bottone EJ, Keusch GT, Weitzman I. Hospital acquired mucormycosis (Rhizopus rhizopodiformis) of skin and subcutaneous tissue: epidemiology, mycology, and treatment . N Engl J Med . 1978;224:1115-1118.Crossref 16. Kidson A, Lowbury EJL. Candida infections of burns . Burns . 1980;6:228-230.Crossref 17. Meyer RD, Young LS, Armstrong D, Yu B. Aspergillosis complicating neoplastic disease . Am J Med . 1973;54:6-15.Crossref 18. Grogan JB. Altered neutrophil phagocytic function in burn patients . J Trauma . 1976;16:734-738.Crossref 19. Burleson DG, Vaughn GK, Mason AD Jr, Pruitt BA Jr. Flow cytometric measurement of rat lymphocyte subpopulations after burn injury and burn injury with infection . Arch Surg . 1987;122:216-220.Crossref 20. Shirani KZ, Vaughan GM, McManus AT, et al. Replacement therapy with modified immunoglobulin G in burn patients: preliminary kinetic studies . Am J Med . 1984;76( (suppl 3A) ):175-180.Crossref 21. Bennett JE. Antifungal agents . In: Mandell GL, Douglas RG Jr, Bennett JE, eds. Principles and Practice of Infectious Diseases . 2nd ed. New York, NY: John Wiley & Sons Inc; 1979:343-353. 22. Desai MH, Herndon DH. Eradication of Candida burn wound septicemia in massively burned patients . J Trauma . 1988;28:140-145.Crossref 23. Chia JKS, Pollack M. Amphotericin B induces tumor necrosis factor production by murine macrophages . J Infect Dis . 1989;159:113-116.Crossref 24. Patterson TF, Miniter P, Dijkstra J, Szoka FC Jr, Ryan JL, Andriole VT. Treatment of experimental aspergillosis with novel amphotericin B/cholesterol-sulfate complexes . J Infect Dis . 1989;159:717-724.Crossref 25. Brajtburg J, Powderly WG, Kobayashi GS, Medoff G. Amphotericin B: current understanding of mechanisms of action . Antimicrob Agents Chemother . 1990;34:183-188.Crossref 26. Dismukes WE. Azole antifungal drugs: old and new . Ann Intern Med . 1988;109:177-179.Crossref 27. Kujath P, Lerch K. Secondary mycosis in surgery: treatment with fluconazole . Hosp Formal . 1990;25( (suppl B) ):23-29.
Jones, William G.;Barber, Annabel E.;Kapur, Sandip;Hawes, Arthur J.;Fahey, Thomas J.;Minei, Joseph P.;Shires, G. Tom;Calvano, Steve E.;Shires, G. Tom
doi: 10.1001/archsurg.1991.01410250056009pmid: 1898698
Abstract • Burn wound sepsis in rats results in sustained corticosterone elevations and the prolonged presence of translocated bacteria in the mesenteric lymph nodes (MLNs). To determine if survival of bacteria in the MLNs may be influenced by pathophysiologic corticosterone levels, MLNs were quantitatively analyzed from rats randomized to the following groups: burn wound sepsis (BI); BI with adrenocortical response attenuated by cyclosporine (cyclosporine/BI); or cyclosporine/BI with corticosterone replacement (cyclosporine/BI + P). Although rates of bacterial translocation were similar, corticosterone levels were significantly different among the three groups and correlated with the number of lymphocytes and the number of enteric bacteria present per gram of MLN. Thus, pathophysiologic elevations of corticosterone levels during sepsis may exert an effect that allows survival of translocated bacteria in the MLNs of rats, perhaps due to glucocorticoid-associated alterations in regional immunity. (Arch Surg. 1991;126:50-55) References 1. Berg RD, Owens WE. Inhibition of translocation of viable E coli from the gastrointestinal tract of mice by bacterial antagonism . Infect Immun . 1979;25:820-827. 2. Maejima K, Deitch EA, Berg RD. Bacterial translocation from the gastrointestinal tracts from rats receiving thermal injury . Infect Immun . 1984; 43:6-10. 3. Jones WG, Minei JP, Barber AE, et al. Bacterial translocation and intestinal atrophy after thermal injury and burn wound sepsis . Ann Surg . 1990;211:399-405.Crossref 4. Deitch EA, Maejima K, Berg RD. Effect of oral antibiotics and bacterial overgrowth in the translocation of the gastrointestinal tract microflora in burned rats . J Trauma . 1985;25:385-392.Crossref 5. Deitch EA, Berg R. Endotoxin but not malnutrition promotes bacterial translocation of the gut flora in burned mice . J Trauma . 1987;27:161-166.Crossref 6. Morris SE, Navaratnam N, Townsend CM, Herndon DN. Bacterial translocation and mesenteric blood flow in a large animal model after cutaneous thermal and smoke inhalation injury . Surg Forum . 1988;39:189-191. 7. Ma L, MaJW, Deitch EA, Specian RD, Berg RD. Genetic susceptibility to mucosal damage leads to bacterial translocation in a murine burn model . J Trauma . 1989;29:1245-1251.Crossref 8. Jones WG, Minei JP, Barber AE, Fahey TJ, Shires GT III, Shires GT. Angiotensin converting enzyme inhibition decreases bacterial translocation after burn injury . FASEB J . 1990;4:A953. 9. Jones WG, Barber AE, Minei JP, Fahey TJ, Shires GT III, Shires GT. Differential pathophysiology of bacterial translocation after thermal injury and sepsis. Ann Surg. In press. 10. Jones WG, Minei JP, Barber AE, Fahey TJ, Shires GT III, Shires GT. Additive effects of thermal injury and infection on the small bowel . Surgery . 1990;108:63-70. 11. Meakins JL. The physiologic defense against infection . In: Burke JF, ed. Surgical Physiology . Philadelphia, Pa: WB Saunders Co; 1983:27-32. 12. Calvano SE, Albert JD, Legaspi A, et al. Comparison of numerical and phenotypic leukocyte changes during constant cortisol infusion in normal humans with those in thermally injured patients . Surg Gynecol Obstet . 1987;164:509-520. 13. Hirano T, Kenji Y, Oka K. Effects of cyclosporine on adrenocortical stress response of Wistar rats . Res Commun Chem Pathol Pharmacol . 1988;60:3-17. 14. Walker HL, Mason AD. A standard animal burn . J Trauma . 1968;8:1049-1056.Crossref 15. Yurt RW, McManus AT, Mason AD, Pruitt BA. Increased susceptibility to infection related to extent of burn injury . Arch Surg . 1984;119:183-188.Crossref 16. Minei JP, Fong Y, Marano MA, et al. Hepatocellular membrane function during chronic burn injury . J Surg Res . 1989;46:311-316.Crossref 17. Richardson RP, Rhyne CD, Kumar A, de Riesthal H, Antonacci AC, Calvano SE. Chronic pathophysiologic elevations of plasma corticosterone promote postburn mortality. In: Proceedings of the 21st Annual Meeting of the American Burn Association; March 30, 1989; New Orleans, La. 18. Keith LD, Winslow JR, Reynolds RW. A general procedure for estimation of corticosteroid response in individual rats . Steroids . 1978;31:523-529.Crossref 19. Organ BC, Antonacci AC, Chiao J, et al. Changes in lymphocyte number and phenotype in seven lymphoid compartments after thermal injury . Ann Surg . 1989;210:78.Crossref 20. Zar JH. Biostatistical Analysis . 2nd ed. 1980; Englewood Cliffs, NJ: Prentice Hall International Inc; 1980. 21. Maddaus MA, Wells CA, Platt JL, Condie RM, Simmons RL. Effect of T cell modulation on the translocation of bacteria from the gut and mesenteric lymph node . Ann Surg . 1987;207:387-398.Crossref 22. Ziegler TR, Smith RJ, O'Dwyer ST, et al. Increased intestinal permeability associated with infection in burn patients . Arch Surg . 1988;123:1313-1319.Crossref 23. Deitch EA. Intestinal permeability is increased in burn patients shortly after injury . Surgery . 1990;107:411-416. 24. Maejima K, Deitch EA, Berg RD. Promotion by burn stress of the translocation of bacteria from the gastrointestinal tracts of mice . Arch Surg . 1984;119:166-172.Crossref 25. Navaratnam N, Morris S, Townsend C, Traber DL, Traber LD, Herndon DN. Bacterial translocation and selective mesenteric artery perfusion with nitroprusside in an ovine model. In: Proceedings of the 21st Annual Meeting of the American Burn Association; April 1, 1989; New Orleans, La. Abstract 179. 26. Berg RD, Wommack E, Deitch EA. Immunosuppression and intestinal bacterial overgrowth synergistically promote bacterial translocation . Arch Surg . 1988;123:1359-1363.Crossref 27. Jones WG, Minei JP, Richardson RP, et al. Pathophysiologic glucocorticoid elevations promote bacterial translocation after thermal injury . Infect Immun . 1990;58:3257-3261. 28. Rebuffat P, Kassprzak A, Andreis PG, et al. Effects of prolonged cyclosporine-A treatment on the morphology and function of rat adrenal cortex . Endocrinology . 1989;125:1407-1413.Crossref 29. Burleson DG, Mason AD, Pruitt BA. Lymphoid subpopulation changes after thermal injury and thermal injury with infection in an experimental model . Ann Surg . 1988;207:208-212.Crossref 30. Powderly WG, Pier GB, Markham RB. In vitro T cell–mediated killing of Pseudomonas aeruginosa vs generation of bactericidal T cells in nonresponder mice . J Immunol . 1987;138:2272-2277. 31. Ralph P, Ito M, Broxmeyer HE, Nakoinz I. Corticosteroids block newly induced but not constitutive functions of macrophage cell lines: myeloid colonystimulating activity production, latex phagocytosis, and antibody-dependent lysis of RBC and tumor targets . J Immunol . 1978;121:300-303. 32. Nugent KM, Pesanti EL. Chronic glucocorticosteroid therapy impairs staphylococcal clearance from murine lungs . Infect Immun . 1982;38:1033-1036. 33. Wells CL, Maddaus MA, Simmons RL. Proposed mechanisms for the translocation of intestinal bacteria . Rev Infect Dis . 1988;10:958-969.Crossref
Waymack, J. Paul;Fernandes, Gabriel;Cappelli, Patricia J.;Burleson, David G.;Guzman, Rey F.;Mason, Arthur D.;Pruitt, Basil A.
doi: 10.1001/archsurg.1991.01410250065010pmid: 1985635
Abstract • The effect of blood transfusions and anesthesia on host response to endotoxin was evaluated in multiple Lewis rat models. The rats were randomized to receive A'Sogaloff Cancer Institute rat blood, pentobarbital sodium, or lactated Ringer's solution and, at either 2 or 7 days following administration of these agents, were challenged with intravenous endotoxin. Neither blood transfusions nor anesthesia altered mortality when administered 2 days before endotoxin challenge. However, blood transfusions administered 7 days before endotoxin challenge were found to prolong survival, to prevent endotoxin-induced alterations in T-lymphocyte subsets, and to decrease plasma tumor necrosis factor levels. In conclusion, blood transfusions appear to depress immune function in a beneficial manner in endotoxin shock. (Arch Surg. 1991;126:59-62) References 1. Landsteiner K. Zur kenntais der antifermentativen, lytisichen und agglutinierenden wirkungen des blutserums un der lymphe . Zentralbl Bakteriol I Abt . 1900;27:357-360. 2. Taylor G, Larson CP Jr, Prestwich R. Unexpected cardiac arrest during anesthesia and surgery: an environmental study . JAMA . 1976;236:2758-2760.Crossref 3. Slade MS, Simmons RL, Yunis E, Greenberg LJ. Immunodepression after major surgery in normal patients . Surgery . 1975;78:363-372. 4. Waymack JP, Alexander JW. Blood transfusions as an immunomodulator: a review . Comp Immunol Microbiol Infect Dis . 1986;9:177-183.Crossref 5. Waymack JP, Miskell P, Gonce S. Alterations in host defense associated with inhalation anesthesia and blood transfusion . Anesth Analg . 1989;69: 163-168.Crossref 6. Howard RJ, Simmons RL. Acquired immunologic deficiencies after trauma and surgical procedures . Surg Gynecol Obstet . 1974;139:771-782. 7. Waymack JP. The effect of blood transfusions on resistance to bacterial infections . Transplant Proc . 1988;20:1105-1107. 8. Männel DN, Northoff H, Bauss F, Falk W. Tumor necrosis factor: a cytokine involved in toxic effects of endotoxin . Rev Infect Dis . 1987;9( (suppl 5) ):S602-S606.Crossref 9. Waymack JP, Moldawer LL, Lowry SF, et al. Effect of prostaglandin E in multiple experimental models, IV: effect on resistance to endotoxin and tumor necrosis factor shock . J Surg Res . 1990;49:328-332.Crossref 10. Waymack JP, Gallon L, Barcelli U, Trocki O, Alexander JW. Effect of blood transfusions on immune function, III: alterations in macrophage arachidonic acid metabolism . Arch Surg . 1987;122:56-60.Crossref 11. Jackson V, Tsakiris D, Tonner E, Briggs JD, Junor BJR. In vitro prostaglandin-E production following multiple blood-transfusions in dialysis patients . Transplant Proc . 1985;17:2386-2388. 12. Lenhard V, Gemsa D, Opelz G. Transfusion-induced release of prostaglandin-E2 and its role in activation of T-suppressor cells . Transplant Proc . 1985;17:2380-2382. 13. Roy R, Lachance JG, Beaudoin R, Grose JH, Noel R. Prostaglandindependent suppressor factor induced following 1-5 blood-transfusions: role in kidney graft outcome . Transplant Proc . 1985;17:2383-2385. 14. Waymack JP, Robb E, Alexander JW. Effect of transfusion on immune function in a traumatized animal model, II: effect on mortality rate following septic challenge . Arch Surg . 1987;122:935-939.Crossref
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