ENDOTOXEMIA, ENCEPHALOPATHY, AND MORTALITY IN CIRRHOTIC-PATIENTS

  • 1 January 1987
    • journal article
    • research article
    • Vol. 82  (1) , 11-15
Abstract
Endotoxemia without sepsis was detected with a chromogenic Limulus assay in 36 of 39 (92.3%) cirrhotic patients and was absent in seven healthy volunteers. In 11 patients who underwent elective portasystemic shunt, portal vein endotoxemia was higher than inferior vena caval: p < 0.05, systemic endotoxin levels did not change, compared to preoperative levels, on the 1st, 2nd and 3rd postoperative days, attendant to an uneventful recovery. In 21 patients in hepatic encephalopathy after esophagogastric hemorrhage, systemic endotoxemia was higher than in well-compensated cirrhotics: p < 0.001; it was higher in deep than in light coma: P < 0.05; it was higher in those who died than in those who survived: P < 0.001. Endotoxin levels showed a positive correlation with serum bilirubin: r = 0.59, P < 0.001, and a negative correlation with prothrombin activity: r = -0.59, P < 0.001. These data show 1) endotoxemia without sepsis is a constant finding in cirrhosis and 2) increasing levels of endotoxemia are associated with hepatic failure, encephalopathy, and death.

This publication has 1 reference indexed in Scilit: