[Endotoxinemia and bacteremia in manual oral decompression of ileus]

In the framework of the present clinical prospective study using a randomly selected patient collective, the question was pursued whether manual oral decompression (MOD), done in connection with surgical intervention in severely ill patients with ileus of the large and small intestine, leads to detectable bacteremia or higher concentrations of endotoxin in serum. From October, 1985 to March, 1987, bacteriological tests were conducted and the endotoxin concentrations in serum were measured in a total of 31 patients. 71% of the patients were female and 29% were male, aged 18-89. The endotoxin measurement was conducted with the aid of the limulus-amoebocyte-lysate (LAL) test, modified according to Piotrowicz. Additionally, bacteriological tests were done of the operation sites and the decompressed gastro-intestinal secretions. Simultaneously, cultures from the central blood stream were prepared. The tests showed that bacteremia and endotoxinemia occur in connection with manual oral decompression (MOD). Neither of the two, however, has any clinically relevant influence on the further post-operative course. Thus, manual oral decompression continues to represent an indispensable maneuver in the surgical management of an ileus.