[Severe surgical infection and DIC].

Severe surgical infection is one of the most obvious clinical settings of DIC. Although many initiating triggers have been discussed, the most potent might be a bacterial endotoxin which activates Hageman factor or some components of serum complement. We examined a disorder of blood coagulation system in severe surgical infection in terms of the results of limulus test for detection of circulating endotoxin. In 59 of such patients, 10 cases (32.3%) of DIC diagnosed by MINNA 's criteria were recognized in 31 limulus positive cases, whereas only 4 cases (14.3%) in 28 limulus negative groups. Each clinical course, prognosis, or the relationship with MOF were also discussed in detail. It was emphasized that the first requirement for diagnosis of DIC should be awareness of its possibility and careful observation of platelet counts. The immediate needs for treatment of DIC are (1) a cure of underlying infection by surgical drainage and chemotherapy, and (2) inhibition of intravascular coagulation by use of heparin and/or FOY etc. Our experiments performed by a continuous drop infusion of both 0.2 mg/kg 055; B5 E. Coli endotoxin and several doses of FOY for 4 hours into rabbits showed that the most potent inhibitory effect of FOY on platelet and WBC was observed in 0.1 mg/kg/min.