Relationship between Plasma Levels of Lipopolysaccharide (LPS) and LPS‐Binding Protein in Patients with Severe Sepsis and Septic Shock

Plasma endotoxin and lipopolysaccharide-binding protein (LBP) levels were measured in a group of 253 patients at the onset of severe sepsis and/or septic shock. Endotoxin levels were significantly greater than control levels (n = 33; mean ± SD, 5.1 ± 7.3, pg/mL) in 78.3% of patients. Median endotoxin levels in patients with sepsis were 300 pg/mL (25%–75% interquartile range, 110–726 pg/mL). LBP levels were elevated in 97% of patients compared with normal control values of 4.1 ± 1.65 µg/mL. Median LBP levels in patients with sepsis were 31.2 µg/mL (interquartile range, 22.5–47.7 µg/mL). Median endotoxin levels at study entry were more highly elevated (515 vs. 230 pg/mL; P < .01), and LBP levels were less highly elevated (28.0 vs. 33.2 µg/mL; P < .05) in nonsurvivors than survivors over the 28-day study period. No correlation was found between endotoxin and LBP levels. The quantitative level of both endotoxin and LBP may have prognostic significance in patients with severe sepsis.