J.Jpn. Surg. Soc.. 78(5): 423-432, 1977

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Original article

TOTAL BODY WASHOUT FOR THE TREATMENT OF EXPERIMENTAL ENDOTOXIN SHOCK

Septic shock (or endotoxin shock) is currently one of the most common causes of hospital mortality despite aggressive medical treatment. The present experiments were designed to remove circulating endotoxin and to reverse shock by means of total body washout.
Seventeen rabbits received Escherichia coli endotoxin (5 mg/kg) and were observed 12 hours . Fourteen rabbits developed acidosis and hypotension and died within the observation period. Thus, the survival rate was 18%.
Seventeen rabbits were subjected to total body washout only. The procedure was performed as follows. Under general anesthesia, partial cardiopulmonary bypass employing a peripheral cannulation technique was carried out to cool the muscle temperature to 25℃. Then the animals were completely exsanguinated. After residual blood was flushed out with cold crystalloid solution, the animals were connected to another pump oxygenator circuit primed with homologus blood and were rewarmed. Fourteen animals survived (82%).
Two hours after the injection of E. coli endotoxin, seventeen rabbits were treated with total body washout. The survival rate 53% of this group was higher than in the nontreated group (18%)
These results indicate that total body washout is a safe and effective method to treat experimental endotoxin shock. Furthermore, the application of total body washout for the treatment of clinical septic shock is discussed.

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