Recognition and treatment of endotoxemia

Endotoxemia occurs secondary to several diseases that disrupt the mucosal barrier to bacteria or their toxins. The effects of endotoxemia are varied and are mediated by a wide variety of proinflammatory substances. Although evidence certainly exists to incriminate the cyclooxygenase-derived products of arachidonic acid in the early responses to endotoxemia, various other mediators must also be considered. Treatment presently involves fluid replacement, correction of acid-base abnormalities, augmentation of cardiovascular function, and inhibition of cyclooxygenase activity.