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Endotoxin, prekallikrein, complement and systemic vascular resistance. Sequential measurements in man
The American Journal of Medicine
|July 1, 1975
Summary
Endotoxemia or gram-positive bacteremia after urinary procedures can cause a drop in systemic vascular resistance. This is linked to lower prekallikrein levels and potential complement system activation.
Area of Science:
- Urology
- Immunology
- Critical Care Medicine
Background:
- Transurethral resection and cystoscopy can lead to complications.
- Endotoxemia and bacteremia are potential risks during urological procedures.
Purpose of the Study:
- To investigate the relationship between endotoxemia/bacteremia and physiological changes after urological procedures.
- To assess the impact of these infections on hemodynamic parameters and complement system activation.
Main Methods:
- Studied 18 patients before and after transurethral resection or cystoscopy.
- Measured hemodynamic parameters, endotoxin (Limulus assay), bacteremia, prekallikrein, C3, C3 proactivator, and lysosomal enzymes.
Main Results:
- Five patients had positive Limulus assays for endotoxin; one had gram-positive bacteremia.
- These six patients showed decreased prekallikrein, C3, or C3 proactivator and reduced systemic vascular resistance.
- Patients without endotoxemia or bacteremia did not experience a drop in systemic vascular resistance.
Conclusions:
- Acute endotoxemia or gram-positive bacteremia in humans is associated with prekallikrein depletion.
- These infections correlate with decreased peripheral resistance and possible complement system activation.