Prolonged shock in the baboon subjected to infusion of E. coli endotoxin.

This study was designed to examine the response of the baboon during a 24-hour period following Escherichia coli endotoxin infusion. Experiments were conducted on young adult baboons, unrestrained and maintained at a light plane of anesthesia induced with pentobarbital sodium. Light and electron microscopic studies on lung, heart, liver, and kidney were conducted; hematologic changes and physiologic responses were measured. The efficacy of heparin to prevent the coagulopathy and increase survivability was assayed. Hepatic sinusoidal fibrin thrombi with underlying hepatocyte cellular damage was seen in the endotoxin-treated group. In contrast, the experimental group receiving heparin showed no sinusoidal fibrin thrombi but demonstrated hepatocellular damage. Liver dysfunction was indicated by elevation of blood levels of enzymes. Glomerular fibrin thrombi were not present. Although heparin prevented the formation of hepatic thrombi in endotoxin-treated baboons, it did not increase survival. Platelet and complement levels decreased in both experimental groups, while wide variations in white blood cell and fibrinogen levels were observed. Polymorphonuclear leukocyte-platelet aggregations previously reported in the pulmonary vasculature during acute shock were not observed in the present study, and their absence may have been related to the longer time of survival.