J.Jpn. Surg. Soc.. 88(9): 1209-1212, 1987

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Report on the annual meeting

THE CONTROVERSIAL ASPECTS IN THE TREATMENT FOR SEPSIS AND SEPTIC SHOCK
－IN TERMS OF THE TREATMENT FOR DIC AND NUTRITIONAL MANAGEMENT－

The effective control of infectious foci and the prevention of vital organ dysfunction are very important management for severe surgical infection. However, it has been pointed out that some managements for such septic condition might have adverse effects and could worse organ function. In this study, we investigated characteristic aspects of DIC accompanied by sepsis to know the adequate treatment for it, and studied the effect of lipid emulsion administration on hepatic function of septic state.
Clinical and experimental studies showed that in septic condition, activity of plasminogen activator is suppressed and vital organ dysfunction is seen frequently in consequence of inhibited fibrinolysis and predominant microembolism, whereas bleeding tendency is very rare. The administration of lipid emulsion as a part of energy source during long term IVH had easing effect of hepatic dysfunction and preventing effect of hepatic fatty infiltration, those are seen frequently and severely in sepsis receiving IVH without lipid administration.
It is concluded, 1) for the treatment of DIC accompanied by sepsis, protease inhibitor with strong antithrombin activity is more feasible than the one with strong anti-plasmin activity, 2) the administration of lipid emulsion is effective for septic patients receiving long term IVH in terms of preventing hepatic damage.

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