The significance of endotoxin release in experimental and clinical sepsis in surgical patients - Evidence for antibiotic-induced endotoxin release?

Infection

Volumn 26, Issue 2, 1998, Pages 77-84

  Holzheimer, R G ^a  

^a MARTIN LUTHER UNIVERSITY HALLE WITTENBERG   (Germany)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIBIOTIC AGENT; ENDOTOXIN; PEPTIDOGLYCAN;

ABDOMINAL INFECTION; HUMAN; NONHUMAN; PATHOGENESIS; PATHOPHYSIOLOGY; PERITONITIS; REVIEW; SEPSIS; SURGICAL PATIENT;

EID: 0031891814     PISSN: 03008126     EISSN: None     Source Type: Journal    
DOI: 10.1007/BF02767765     Document Type: Review

References (107)

1. Stone, R.: Search for sepsis drugs goes on despite past failures. Science 264 (1994) 365-367.
2. Wittmann, D. H., Bansal, N., Bergstein, J. M., Wallace, J. R., Wittmann, M. M., Aprahamian, C.: Staged abdominal repair compares favourably with conventional operative therapy for intraabdominal infections when adjusting for prognostic factors with a logistic model. Theor. Surg. 9 (1994) 201-207.
3. Wittmann, D. H., Schein, M., Condon, R. E.: Management of secondary peritonitis. Ann. Surg. 224 (1996) 10-18.
4. Kirschner, M.: Die Behandlung der akuten Bauchfellentzündung. Langenbecks Arch. Klin. Chir. 142 (1926) 253-311.
5. Holzheimer, R. G., Cavaillon, J. M., Mosca, F., Haupt, W., Stefani, A., DiStefano, R., Torres, A., Capel, P., Aasen, A., Anderson, I., Schöffel, U.: Clinical and basic science aspects of immune pathogenesis of sepsis and peritonitis. Med. Microbiol. Letters 5 (1996) 386-393.
6. Michie, H. R., Wilmore, D. W.: Sepsis, signals and surgical sequelae (a hypothesis). Arch. Surg. 125 (1990) 531-536.
7. Holzheimer, R. G., Steinmetz, W. G., Ebentreich, U., Kauffmann, T., Jendrissek, A., Franke, S., Engermann, R., Thiede, A.: Aortic aneurysm repair may cause bacterial translocation with concomitant endotoxin release into the systemic circulation and activation of the inflammatory cascade. J. Endotoxin Research 1 (1994) 31.
8. Jackson, J. J., Kropp, H.: Beta-lactam antibiotic induced release of endotoxin: in vitro comparison of penicillin-binding protein (PBP) 2-specific imipenem and PBP 3-specific ceftazidime. J. Infect. Dis. 165 (1992) 1033-1041.
9. Seelen, M. A., Athanassiou, P., Lynn, W. A., Norsworthy, P., Walport, M. J., Cohen, J., Davies, K. A.: The anti-lipid A monoclonal antibody E5 binds to rough gram-negative bacteria, fixes C3, and facilitates binding of bacterial immune complexes to both erythrocytes and monocytes. Immunology 84 (1995) 653-661.
10. Levy, O., Oos, E., Elsbach, P., Doerfler, M. E., Lehrer, R. I., Weiss, J.: Antibacterial proteins of granulocytes differ in interaction with endotoxin. Comparison of bactericidal/permeability increasing protein, p15s, and defensins. J. Immunol. 154 (1995) 5403-5410.
11. Crosby, H. A., Bion, J. F., Penn, C. W., Elliott, T. S.: Antibiotic induced release of endotoxin from bacteria in vitro. J. Med. Microbiol. 40 (1994) 23-30.
12. Bucklin, S. E., Fujihara, Y., Leeson, M. C., Morrison, D. C.: Differential antibiotic-induced endotoxin release from gram-negative bacteria. Eur. J. Clin. Microbiol. Infect. Dis. 13 (Suppl. 1) (1994) 43-51.
13. Foca, A., Matera, G., Berlinghieri, M. C.: Inhibition of endotoxin-induced interleukin 8 release by teicoplanin in human whole blood. Eur. J. Clin. Microbiol. Infect. Dis. 12 (1993) 940-944.
14. Burd, R. S., Battafarano, R. J., Cody, C. S., Farber, M. S., Ratz, C. A., Dunn, D. L.: Anti-endotoxin monoclonal antibodies inhibit secretion of tumor necrosis factor-alpha by two different mechanisms. Ann. Surg. 218 (3) (1993) 250-259.
15. Dofferhoff, A. S., Esselink, M. T., de Vries Hospers, H. G., van Zanten, A., Bom, V. J., Weits, J., Vellenga, E.: The release of endotoxin from antibiotic-treated Escherichia coli and the production of tumor necrosis factor by human monocytes J. Antimicrob. Chemother. 31 (1993) 373-384.
16. Eng, R. H., Smith, S. M., Fan Havard, P., Ogbara, T.: Effect of antibiotics on endotoxin release from gram-negative bacteria. Diagn. Microbiol. Infect. Dis. 16 (3) (1993) 185-189.
17. Arditi, M., Kabat, W., Yogev, R.: Antibiotic-induced bacterial killing stimulates tumor necrosis factor-alpha release in whole blood. J. Infect. Dis. 167 (1993) 240-244.
18. Van den Berg, C., de Neeling, A. J., Schot, C. S., Hustinx, W. N., Wemer, J., de Wildt, D. J.: Delayed antibiotic-induced lysis of Escherichia coli in vitro is corrrelated with enhancement of LPS release. Scand. J. Infect. Dis. 24 (1992) 619-627.
19. Bingen, E., Goury, V., Bennani, H., Lambert Zechovsky, N., Aujard, Y., Darbord, J. C.: Bactericidal activity of beta-lactams and amikacin against Haemophilus influenzae: effect on endotoxin release. J. Antimicrob. Chemother. 30 (1992) 165-172.
20. Dofferhoff, A. S., Nijland, J. H., de Vries Hospers, H. G., Mulder, P. O., Weits, J., Bom, V. J.: Effects of different types and combinations of antimicrobial agents on endotoxin release from gram-negative bacteria: an in-vitro and in-vivo study. Scan. J. Infect. Dis. 23 (1991) 745-754.
21. Simon, D. M., Koenig, G., Trenholme, G. M.: Differences in release of tumour necrosis factor from THP-1 cells stimulated by filtrates of antibiotic-killed Escherichia coli. J. Infect. Dis. 164 (1991) 800-802.
22. Morrison, D. C., Bucklin, S. E., Leeson, M. C., Norimatsu, M.: Contribution of soluble endotoxin released from gram-negative bacteria by antibiotics to the pathogenesis of experimental sepsis in mice. J. Endotoxin Research 3 (1996) 237-243.
23. Bucklin, S. E., Morrison, D. C.: Differences in therapeutic efficacy among cell wall active antibiotics in a mouse model of gram-negative sepsis. J. Infect. Dis. 172 (1995) 1519-1527.
24. Opal, S. M., Horn, D. L., Palardy, J. E., Parejo, N., Jhung, J., Battacharjee, A., Young, L. D.: The in vivo significance of antibiotic-induced endotoxin release in experimental gram-negative sepsis. J. Endotoxin Research 3 (1996) 245-252.
25. Cohen, J., McConnell, J. S.: Release of endotoxin from bacteria exposed to ciprofloxacin and its prevention with polymyxin B. Eur. J. Clin. Microbiol. 5 (1986) 13-17.
26. Artenstein, A. W., Cross, A. S.: Inhibition of endotoxin reactivity by aminoglycosides. J. Antimicrob. Chemother. 24 (1989) 826-828.
27. Healy, D. P., Verst-Brasch, C. L., Clendening, C. E., Neely, A. N., Holder, I. A.: Influence of drug class and dose size on antibiotic-induced endotoxin/IL-6 release and impact on efficacy of antiendotoxin antibody. J. Endotoxin Research 3 (1996) 219-227.
28. Lamp, K. C., Rybak, M. J., McGrath, B. J., Summers, K. K.: Influence of antibiotic and E5 monoclonal immunoglobulin M interactions on endotoxin release from Escherichia coli and Pseudomonas aeruginosa. Antimicrob. Agents Chemother. 40 (1996) 247-252.
29. Morrison, D. C., Bucklin, S. E.: Evidence for antibiotic-mediated endotoxin release as a contributing factor to lethality in experimental gram-negative sepsis. Scand. J. Infect. Dis. Suppl. 101 (1996) 3-8.
30. Nitsche, D., Schulze, C., Oesser, S., Dalhoff, A., Sack, M.: Impact of different classes antimicrobial agents on plasma endotoxin activity. Arch. Surg. 131 (1996) 192-199.
31. Arditi, M., Zhou, J.: Differential antibiotic-induced endotoxin release and interleukin-6 production by human umbilical vein endothelial cells (HUVECs): amplification of the response by coincubation of HUVECs and blood cells. J. Infect. Dis. 175 (1997) 1255-1258.
32. Hurley, J. C.: Antibiotic-induced release of endotoxin: a reappraisal. Clin. Infect. Dis. 15 (1992) 840-854.
33. Casey, L. C., Balk, R. A., Bone, R. C.: Plasma cytokine and endotoxin levels correlate with survival in patients with the sepsis syndrome. Ann. Intern. Med. 119 (1993) 771-778.
34. Bellomo, R.: The cytokine network in the critically ill. Anaesth. Intensive Care 20 (1992) 288-302.
35. Goris, R. J.: Mediators of multiple organ failure. Intensive Care Med. 16 (Suppl. 3) (1990) S192-196.
36. van der Poll, T., Van Deventer, S. J., ten Cate, H., Levi, M., ten Cate, J. W.: Tumor necrosis factor is involved in the appearance of interleukin-1 receptor antagonist in endotoxemia. J. Infect. Dis. 169 (1994) 665-667.
37. Leeson, M. C., Fujihara, Y., Morrison, D. C.: Evidence for lipopolysaccharide as the predominant proinflammatory mediator in supernatants of antibiotic-treated bacteria. Infect. Immun. 62 (1994) 4975-4980.
38. Bone, R. C., Balk, R. A., Cerra, F. B., Dellinger, R. P., Fein, A. M., Knaus, W. A., Schein, R. M. H., Sibbald, W. J.: Definition for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest 101 (1992) 1644-1655.
39. Wewers, M. D., Rinehart, J. J., She, Z. W., Herzyk, D. J., Hummel, M. M., Kinney, P. A., Davis, W. B.: Tumor necrosis factor infusions in humans prime neutrophils for hypochlorous acid production. Am. J. Physiol. 259 (1990) L276-282.
40. Cohen, J., Carlet, J. and the Intersept Study Group: Intersept: an international multicenter, placebo-controlled trial of monoclonal antibody to human tumor necrosis factor-α in patients with sepsis. Crit. Care. Med. 24 (1996) 1431-1440.
41. Morrison, D. C.: Assessment of antibiotic-mediated endotoxin release. J. Endotoxin Research 3 (1996) 275-279.
42. Kelly, J. L., O'Sullivan, C., O'Riordain, M., O'Riordain, D., Lyons, A., Doherty, J., Mannick, J. A., Rodrick, M. L.: Is circulating endotoxin the trigger for the systemic inflammatory response syndrome seen after injury? Ann. Surg. 225 (1997) 530-541.
43. Willatts, S., M., Speller, D. C., Winter, R. J.: Incidence of gram-negative bacteremia in sepsis syndrome. Implications for immunotherapy. Anaesthesia 49 (1994) 751-754.
44. Schöffel, U., Jacobs, E., Ruf, G., Mierswa, F., von Specht, B. U., Farthmann, E. H.: Intraperitoneal microorganisms and the severity of peritonitis. Eur. J. Surg. 161 (1995) 501-508.
45. Berger, D., Schmidt, U. M., Ott, S., Seidelmann, M., Martin, R., Beger, H. G.: Incidence and pathophysiological relevance of postoperative endotoxemia. FEMS Immunol. Med. Microbiol. 11 (1995) 285-290.
46. Berger, D., Boelke, E., Seidelmann, M., Berger, H. G.: Evaluation of endotoxemia for diagnosis of urinary tract infection after major surgical procedures. Clin. Chim. Acta 244 (1996) 155-190.
47. Michie, H. R., Manogue, K. R., Spriggs, D. R.: Detection of circulating tumor necrosis factor after endotoxin administration. N. Engl. J. Med. 318 (1988) 1481-1486.
48. Rintala, E., Pulkki, K., Mertsola, J., Nevalainen, T., Nikoskelainen, J.: Endotoxin, inlerleukin-6 and phospholipase A2 as markers of sepsis with hematological malignancies. Scand. J. Infect. Dis. 27 (1995) 39-43.
49. Weidemann, B., Schletter, J., Dziarski, R., Kusumoto, S., Stelter, F., Rietschel, E. T., Flad, H. D., Ulmer, A. J.: Specific binding of soluble peptidoglycan and muramyldipeptide to CD14 on human monocytes. Infect. Immun. 65 (1997) 858-864.
50. Schromm, A. B., Brandenburg, K., Rietschel, E. T., Flad, H. D., Carroll, S. F., Seydel, U.: Lipopolysaccharide-binding protein mediates CD14-independent intercalation of lipopolysaccharide into phospholipid membranes. FEBS Lett. 399 (1996) 267-271.
51. Schletter, J., Brade, H., Brade, L., Kruger, C., Loppnow, H., Kusumoto, S., Rietschel, E. T., Flad, H. D., Ulmer, A. J.: Binding of lipopolysaccharide (LPS) to an 80-kilodalton membrane protein of human cells is mediated by soluble CD14 and LPS-binding protein. Infect. Immun. 63 (1995) 2576-2580.
52. Seydel, U., Brandenburg, K., Rietschel, E. T.: A case for an endotoxic conformation. Prog. Clin. Biol. Res. 388 (1994) 17-30.
53. Flad, H. D., Loppnow, H., Rietschel, E. T., Ulmer, A. J.: Agonists and antagonists for lipopolysaccharide-induced cytokines. Immunobiology 187 (1993) 303-316.
54. Mattern, T., Thanhauser, A., Reiling, N., Toellner, K. M., Duchrow, M., Kusumoto, S., Rietschel, E. T., Ernst, M., Brade, H., Flad, H. D.: Endotoxin and lipid A stimulate proliferation of human T cells in the presence of autologous monocytes. J. Immunol. 153 (1994) 2996-3004.
55. Bone, R. C., Balk, R. A., Fein, A. M., Perl, T. M., Wenzel, R. P., Reines, H. D., Quenzer, R. W., Iberti, T. J., Macintyre, N., Schein, R. M.: A second large controlled clinical study of E5, a monoclonal antibody to endotoxin: results of a prospective, multicenter, randomized controlled trial. The E5 sepsis study group. Crit. Care Med. 23 (1995) 994-1006.
56. Marra, M. N., Thornton, M. B., Snable, J. L., Wilde, C. G., Scott, R. W.: Endotoxin-binding and -neutralizing properties of recombinant bactericidal/permeability increasing protein and monoclonal antibodies HA-1A and E5. Crit. Care Med. 22 (1994) 559-565.
57. Christ, W. J., Asano, O., Robidoux, A. L., Perez, M., Wang, Y., Dubuc, G. R., Gavin, W. E., Hawkins, L. D., McGuiness, P. D., Mullarkey, M. A.: E5531, a pure endotoxin antagonist of high potency. Science 268 (1995) 80-83.
58. DiPadova, F. E., Brade, H., Barclay, G. R., Poxton, I. R., Liehl, E., Schuetze, E., Kocher, H. P., Ramsay, G., Schreier, M. H., McClelland, D. B.: A broadly cross-protective monoclonal antibody binding to E. coli and Salmonella lipopolysaccharides. Infect. Immun. 61 (1993) 3863-3872.
59. Kuhn, H. M., Brade, L., Appelmelk, B. J., Kusumoto, S., Rietschel, E. T., Brade, H.: The antibody reactivity of monoclonal lipid A antibodies is influenced by the acylation pattern of lipid A and the assay system employed. Immunobiology 189 (1993) 457-471.
60. Goldie, A. S., Fearon, K. C., Ross, J. A., Barclay, G. R., Jackson, R. E., Grant, I. S., Ramsay, G., Blyth, A. S., Howie, J. C.: Natural cytokine antagonists and endogenous antiendotoxin core antibodies in sepsis syndrome. The Sepsis Intervention Group. JAMA 274 (1995) 172-177.
61. Bennett Guerrero, E., Ayuso, L., Hamilton Davis, C., White, W. D., Barclay, G. R., Smith P. K., King, S. A., Muhlbaier, L. H., Newman, M. F., Mythen, M. G.: Relationship of preoperative antiendotoxin core antibodies and adverse outcomes following cardiac surgery. JAMA 277 (1997) 646-650.
62. Urbaschek, B., Ditter, B., Becker, K. P., Urbaschek, R.: Protective effects and role of endotoxin in experimental septicemia. Circ. Shock 14 (2984) 209-222.
63. Urbaschek, R., Becker, K. P.: Endotoxinnachweis im Plasma: Spezifität und Aussagekraft für Entwicklung und Prognose einer Sepsis. Infusionsther. Transfusionsmed. 20 (Suppl. 1) (1993) 16-20.
64. Nishida, J., Ekataksin, W., McDonnell, D., Urbaschek, R., Urbaschek, B., McCuskey, R.S.: Ethanol exacerbates hepatic microvascular endotoxemia and lethality in septic mice. Schock 1 (1994) 413-418.
65. Prins, J. M., Kuijper, E. J., Mevissen, M. L. C. M., Speelman, P., van Deventer, S. J. H.: Release of tumor necrosis factor alpha and interleukin 6 during antibiotic killing of Escherichia coli in whole blood: of antibiotic class, antibiotic concentration and presence of septic serum. Infect. Immun. 63 (1995) 2236-2242.
66. Patel, R. T., Deen, K. I., Youngs, D., Warwick, J., Keighley, M. R.: Interleukin 6 is a prognostic indicator of outcome in severe intraabdominal sepsis. Br. J. Surg. 81 (1994) 1306-1308.
67. de Bont, E. S., Martens, A., van Raan, J., Samson, G., Fetter, W. P., Okken, A., de Leij, L. H., Kimpen, J. L.: Diagnostic value of plasma levels of tumor necrosis factor alpha (TNF alpha) and interleukin-6 (IL-6) in newborns with sepsis. Acta Paediatr. 83 (1994) 696-699.
68. Fugger, R., Zadrobilek, E., Gotzinger, P., Klimann, S., Rogy, M., Winkler, S., Andel, H., Mittelbock, M., Roth, E., Schulz, F.: Perioperative TNF alpha and IL-6 concentrations correlate with septic state, organ function, and Apache II scores in intraabdominal infection. Eur. J. Surg. 159 (1993) 525-529.
69. Holzheimer, R. G., Schein, M., Wittmann, D. H.: Inflammatory response in peritoneal exudate and plasma of patients undergoing planned relaparotomy for severe peritonitis. Arch. Surg. 130 (1995) 1314-1320.
70. Holzheimer, R. G., Cavaillon, J. M., Aasen, A. O., Cainzos, M., Schöffel, U.: Clinical routine determination as part of a European Research Network. Shock 7 (1997) 121.
71. Echtenacher, B., Falk, W., Männel, D. N., Krammer, P. H.: Requirements of endogenous tumor necrosis factor/cachectin for recovery from experimental peritonitis. J. Immunol. 145 (1990) 3762-3766.
72. Bagby, G. J., Plessala, K. J., Wilson, L. A., Thompson, J. J., Nelson, S.: Divergent efficacy of antibody to tumor necrosis factor alpha in intravascular and peritonitis models of sepsis. J. Infect. Dis. 163 (1991) 83-88.
73. Villa, P., Sartor, G., Angelini, M., Sironi, M., Conni, M., Gnocchi, P., Isetta, A. M., Grau, G., Buurman, W., van Tits, L. J.: Pattern of cytokines and pharmacomodulation in sepsis induced by cecal ligation and puncture compared with that induced by endotoxin. Clin. Diagn. Lab. Immunol. 2 (1995) 549-553.
74. Schein, M., Wittmann, D. H., Holzheimer, R., Condon, R. E.: Hypothesis: compartmentalization of cytokines in intraabdominal infection. Surgery 119 (1996) 694-700.
75. Holzheimer, R. G., Molloy, R., Mendez, M. V., O'Riordain, D., Curley, P., Nestor, M., Collins, K., Saporoschetz, I., Mannick, J. A., Rodrick, M. L.: Multiple system organ failure may be influenced by macrophage hypoactivation as well as hyperactivation - importance of the double challenge. Eur. J. Surg. 161 (1995) 795-803.
76. Hau, T., Ahrenholz, D. H., Simmons, R. L.: Secondary bacterial peritonitis: the biological basis of treatment. Curr. Probl. Surg. 16 (1979) 1.
77. Hau, T., Mozes, M. F., Jonasson, O.: Peritonitis nach Nierentransplantation. Langenbecks Arch. Chir. 353 (1981) 269.
78. Holzheimer, R. G., Quoika, P., Pätzmann, D., Füssle, R.: Nosocomial infections in general surgery: surveillance report from a German university clinic. Infection 18 (1990) 219-225.
79. Christou, N. V., Turgeon, P., Wassef, R., Rotstein, O., Bohnen, J., Potvin, M.: Management of intraabdominal infections. The case for intraoperative cultures and comprehensive broad-spectrum antibiotic coverage. The Canadian Intraabdominal Infection Study Group. Arch. Surg. 131 (1996) 1193-1201.
80. Cross, A., Asher, L., Seguin, M., Yuan, L., Kelly, N., Hammack, C., Sadoff, J., Gemski, P.: The importance of lipopolysaccharide-initiated, cytokine-mediated host defense mechanism in mice against extraintestinally invasive Escherichia coli. J. Clin. Invest. 96 (1995) 676-686.
81. Prins, J. M., Kuijpers, E. J., Mevissen, M. L., Speelman, P., van Deventer, S. J.: Release of tumor necrosis factor alpha and interleukin 6 during antibiotic killing of Escherichia coli in whole blood: influence of antibiotic class, antibiotic concentration, and presence of septic serum. Infect. Immun. 63 (1995) 2236-2242.
82. Rosman, C., Westerveld, G. J., van Oeveren, W., Kooi, K., Bleichrodt, R. P.: Effect of intraperitoneal microbials on the concentration of bacteria, endoloxin, and tumor necrosis factor in abdominal fluid and plasma in rats. Eur. Surg. Res. 28 (1996) 351-360.
83. Hurley, J. C.: Antibiotic-induced release of endotoxin. A therapeutic paradox. Drug Saf. 12 (1995) 183-195.
84. Stone, H. H., Kolb, L. D., Geheber, C. E.: Incidence and significance of intraabdominal infections. Ann. Surg. 181 (1975) 705-715.
85. Lorber, B., Swenson, R. M.: The bacteriology of intraabdominal infection. Surg. Clin. North Am. 55 (1975) 1349-1354.
86. Rotstein, O.: Peritonitis and intraabdominal abscesses. In: Meakins, J. L. (ed.): Surgical infections - diagnosis and treatment. Scientific American Medicine Inc., New York 1994, pp. 329-351.
87. Prins, J. M., van Agtmael, M. A., Kuijper, E. J., van Deventer, S. J., Speelman, P.: Antibiotic-induced endotoxin release in patients with gram-negative urosepsis: a double-blind study comparing imipenem and ceftazidime. J. Infect. Dis. 172 (1995) 886-891.
88. Arditi, M., Ables, L., Yoger, R.: Cerebrospinal fluid endotoxin levels in children with H. influenzae meningitis before and after iv ceftriaxone. I. Infect. Dis. 160 (1990) 1005-1011.
89. Hurley, L. C., Louis, W. J., Tosolini, F. A., Carlin, J. B.: Antibiotic induced release of endotoxin in chronically bacteriuric patients. Antimicrob. Agents Chemother. 35 (1991) 2388-2394.
90. Prins, J. M.: Antibiotic induced release of endotoxin - clinical data and human studies. J. Endotoxin Research 3 (1996) 269-273.
91. Mock, C. N., Jurkovich, G. J., Dries, D. J., Maier, R. V.: Clinical significance of antibiotic endotoxin releasing properties in trauma patienls. Arch. Surg. 130 (1995) 1234-1240.
92. Holzheimer, R. G., Hirte, J. F., Reith, B., Engelhardt, W., Horak, K. H., Leppert, R., Aasen, A., Capel, P., Urbaschek, R., Karch, H., Thiede, A.: Different endotoxin release and IL-6 plasma levels after antibiotic administration in surgical intensive care patients. J. Endotoxin Research 3 (1996) 261-267.
93. Morrison, D. C.: Assessment of antibiotic mediated endotoxin release. J. Endotoxin Research 3 (1996) 173-178.
94. Brandenburg, K., Seydel, U., Schromm, A. B., Loppnow, H., Koch, M. H. J., Rietschel, E. T.: Conformation of lipid A, the endotoxic center of bacterial lipopolysaccharide. J. Endotoxin Research 3 (1996) 173-178.
95. Opal, S. M., Horn, J. E., Palardy, J. E., Parejo, N., Jhung, J., Battacharjee, A., Young, L. D.: The in vivo significance of antibiotic-induced endotoxin release in experimental gram-negative sepsis. J. Endotoxin Research 3 (1996) 245-252.
96. Biffl, W. L., Moore, E. E., Moore, F. A., Peterson, V. M.: Interleukin 6 in the injured patient - marker of injury or mediator of inflammation? Ann. Surg. 224 (1996) 647-664.
97. Tang, G. J., Kuo, C. D., Yen, T. C., Kuo, H. S., Chan, K. H., Yien, H. W., Lee, T. Y.: Perioperative plasma concentrations of tumor necrosis factor-alpha and interleukin-6 in infected patienls. Crit. Care Med. 24 (1996) 423-428.
98. Wittmann, D. H.: Immunological consequences of antibiotic therapy. In: Engemann, R., Holzheimer, R. G., Thiede, A. (eds): Immunology and its impact on infections in surgery. Springer Verlag. Heidelberg Berlin New York 1995, pp. 217-223.
99. Astiz, M. E., Rackow, E. C., Still, J. G., Howell, S. T., Cato, A., Von Eschen, K. B., Ulrich, J. T., Rudbach, J. A., McMahon, G., Vargas, R.: Pretreatment of normal humans with monophosphoryl lipid A induces tolerance to endotoxin: a prospective, double-blind. randomized, controlled trial. Crit. Care Med. 23 (1995) 9-17.
100. Bone, R. C., Balk, R. A., Fein, A. M., Perl, T. M., Wenzel, R. P., Reines, H. D., Quenzer, R. W., Iberti, T. J., MacIntyre, N., Schein, R. M.: A second large clinical study of E5, a monoclonal antibody to endotoxin: results of a prospective, multicenter randomized, controlled trial. The E5 Sepsis Study Group. Crit. Care Med. 23 (1995) 994-1006.
101. Greenman, R. L., Schein, R. M., Martin, M. A., Wenzel, R. P., MacIntyre, N. R., Emmanuel, G., Chmel, H., Kohler, R. B., McCarty, M., Plouffe, J.: A controlled clinical trial of E5 murine monoclonal IgM antibody to endotoxin in the treatment of gram-negative sepsis. The XOMA Sepsis Study Group. JAMA 266 (1991) 1097-1102.
102. Rogy, M. A., Oldenburg, H. S. A., Coyle, S., Trousdale, R., Moldawer, L. L., Lowry, S. F.: Correlation between acute physiology and chronic health evaluation (Apache) III score and immunological parameters in critically ill patients with sepsis. Br. J. Surg. 83 (1996) 396-400.
103. Holzheimer, R. G., Haupt, W., Thiede, A., Schwarzkopf, A.: The challenge of postoperative infections: does the surgeon make a difference? Infect. Control Hosp. Epidemiol. 18 (1997) 449-456.
104. Imhof, M., Bauer, M.: Time series analysis in critical care monitoring. New Horizons 4 (1996) 519-531.
105. Aasen, A. O., Solberg, R., Sveen, O., Gallimore, M. J., Holzheimer, R. G.: Consequences of trauma on circulating cells and the plasma cascade systems, In: Risberg, B.: Trauma care - an update. Pharmacia & Upjohn, Stockholm, Sweden 1996, 118-128.
106. Hesselvik, J. F., Blombäck, M., Brodin, B., Maller, R.: Coagulation, fibrinolysis, and kallikrein systems in sepsis: relation to outcome, Crit. Care Med. 17 (1989) 724-733.
107. Aasen, A. O.: The proenzyme functional inhibition index. A new parameter for the evaluation of severely injured and septic patients. Acta Chir. Scand. Suppl. 522 (1985) 211-233.