Anti-endotoxin in the treatment of severe surgical septic shock. Results of a randomized double-blind trial

Abstract

A randomized double-blind trial of human antilipopolysaccharide (anti-LPS)-specific globulin (LG-1) versus placebo (albumin) in the treatment of severe septic shock of surgical origin was carried out over a 6-month period from June to December 1983. Hospital mortality was 10 patients (59%) out of 17 in the control group and 9 out of 17 (53%) in the treated group. Irreversible shock was the cause of death in 4 patients (23,5%) in the control group and 5 (29,4%) in the treated group. Duration of hospital stay of the survivors averaged 44 days for the control group and 62 for the treated group. Measurement of serum endotoxin and anti-LPS levels at the time of admission to the study and 24 hours later revealed no significant difference between controls and treated patients. Significantly higher mortality rates were observed in patients who were endotoxemic after 24 hours of treatment compared with those who were not (chi 2 = 4,80; P less than 0,025).