Host resistance in hemorrhagic shock XV. Isolation of toxic factor from hemorrhagic shock plasma.

Abstract

1) Previous observations on the toxicity of plasma from animals in irreversible hemorrhagic shock were confirmed and extended by the isolation of a toxic polysaccharide fraction from this plasma which cannot be isolated, under identical conditions, from normal plasma. The ability of this polysaccharide fraction to elicit responses characteristic of bacterial endotoxins, and to convert the reversible to the irreversible state of hemorrhagic shock has been demonstrated. The ability of bacterial endotoxins, in turn, to elicit the lesions characteristic of shock, was reviewed. 2) Although the entire quantity of toxic polysaccharide circulating in the irreversibly shocked animal is innocuous to a normal animal, only a fraction of the total is sufficient to inflict lethal injury to an animal with its defenses already depleted by reversible shock. The mounting evidence for the presence of endotoxemia in shock provides a logical basis for incriminating the loss of functional integrity of the R.E. system in the development of irreversibility to transfusion in hemorrhagic shock, and for an understanding of the phenomenon of variation in resistance to shock under different conditions. The development of irreversibility to transfusion in hemorrhagic shock in the germ-free animal is discussed in the light of these considerations.