Abstract
Sepsis and multiple-organ failure are common sequelae of multiple trauma. Although sepsis is considered to result from bacteria translocating through the gut mucosa, evidence for that is lacking. In order to define the chronic involvement of bacterial translocation, fracture was induced after crushing of the right femor on its mid in 11 rabbits. Blood was collected at regular time intervals for quantitative culture and for estimation of endotoxins (LPS) by the QCL LAL-assay, tumor necrosis factor-alpha (TNFalpha) by a bioassay in L929 fibrosarcoma cell line and malondialdehyde (MDA) by HPLC. After death, segments of liver, lung and spleen were cut for quantitative culture. Mean +/−SE of the log10 of viable cells in blood were 2.48 +/− 0.43, 3.16 +/− 0.46, 2.77 +/− 0.69 and 2.12 +/− 0.43 at 2, 4, 24 and 48 hours after fracture. Respective values for LPS were 1.50 +/−0.29, 1.54 +/− 0.44, 1.17 +/− 0.17 and < 1.00; for MDA 3.57 +/− 0.55, 7.50 +/− 3.00, 15.77 +/− 12.26 and 5.07 +/− 2.18 μM; and for TNFalpha 11.8 +/− 1.2, 36.7 +/− 25.9, 40.7 +/− 24.0 and 56.8 +/− 45.3 pg/ml. Positive tissue cultures for Serratia marscecens and Pseudomonas aeruginosa were found for six rabbits. Median survival for animals drawn positive tissue cultures was 1.00 days and 7.00 days for animals with negative tissue cultures (p: 0.0092). It is concluded that bacterial translocation is a process occurring early in a significant percentage in the field of multiple trauma. Its occurrence is accompanied by rapid progression to death. Further research is mandatory to clarify the reasons favoring that process in certain hosts compared to others.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
