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Purification and Visualization of Lipopolysaccharide from Gram-negative Bacteria by Hot Aqueous-phenol Extraction
Published on: May 28, 2012
Rewarming from hypothermia leads to elevated plasma lipopolysaccharide concentrations
S L Gaffin1, F B Dietz, J G Brock-Utne
1Military Nutrition and Biochemistry Division, US Army Research Institute for Environmental Medicine, Natick, Massachusetts, USA.
Summary
Hypothermia rewarming can cause vascular instability due to bacterial lipopolysaccharide (LPS) translocation from the gut. A study found temporary endotoxemia in 63.6% of patients, potentially mitigated by dexamethasone.
Area of Science:
- Medical Research
- Physiology
- Immunology
Background:
- Rewarming hypothermia victims can cause dangerous vascular instability, multiorgan failure, and shock.
- The underlying causes of these rewarming complications are unknown but may involve bacterial lipopolysaccharide (LPS).
Purpose of the Study:
- To investigate the presence and timing of LPS spikes during hypothermic surgery and rewarming.
- To explore the potential link between splanchnic ischemia, LPS translocation, and rewarming complications.
Main Methods:
- Measured LPS levels during cooling and rewarming phases in 11 patients undergoing hypothermic surgery.
- Correlated LPS spikes with surgical events and patient outcomes.
- Observed the effect of pre-operative dexamethasone administration on LPS levels.
Main Results:
- Temporary endotoxemia (LPS spike) occurred in 7/11 (63.6%) patients, primarily at the start of rewarming.
- Four patients who received dexamethasone pre-surgery showed no LPS spike.
- Hypothermia likely caused splanchnic ischemia, leading to gut wall damage and LPS translocation.
Conclusions:
- Rewarming after hypothermia carries a risk of endotoxemia due to LPS translocation.
- Dexamethasone may protect the gut wall, preventing LPS translocation.
- Further research is needed to confirm these findings and explore therapeutic implications.
