Role of the Intestinal Flora in Major Trauma

Abstract

The Limulus-lysate test revealed endotoxin in postmortem tissue homogenates of 20 of a random series of 35 patients. Data indicated that the finding of endotoxin in the livers of these patients signified an endotoxemia consequent on a failure of the endotoxin-detoxifying mechanisms. Endotoxemia was associated with a high incidence of gastrointestinal bleeding, hemorrhagic ulceration of the gastrointestinal mucosa, acute pulmonary pathology, and major injury to the liver. The absence of a septic focus as a source for endotoxemia in many of these patients is consistent with evidence that endotoxemia of intestinal origin commonly develops when the antibacterial defense mechanism has been depleted as a result of severe damage to the reticuloendothelial system.