Correlation between Circulatory Status and Energy Metabolism in Various Tissues during Endotoxin Shock
The living cell is a highly organized system dependent upon a continuous generation of energy. For this generation, oxygen is the most essential of all substrates. It is therefore a very reasonable hypothesis that the lethal effects of endotoxins may exert themselves by inhibiting oxygen consumption. There are two basic possibilities to be considered: First, an interference with capillary exchange mechanisms followed by hypoxic intracellular damage, and, second, a specific toxic inhibition of cellular metabolism, due either to the large endotoxin molecule itself, or, more likely, to low-molecular humoral mediators. Since the most ominous clinical sign of endotoxinemia is shock, or an acute hemodynamic disturbance affecting cellular oxygen supply, we need to know whether the intracellular disorganization which may ultimately kill the patient originates within the circulation or inside the cell itself. The answer to this question has not only theoretical, but also eminently practical implications. As a point of departure for this session on hemodynamics and metabolism, I should like to present very briefly some studies we have performed to elucidate this problem.
KeywordsBlood Parameter Endotoxin Shock Redox Ratio Endotoxin Action Reaction Equilibrium Constant
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