Alterations in intestinal permeability after thermal injury.
Alterations in intestinal permeability have been postulated to occur after thermal injury. We evaluated the status of intestinal permeability during the first 2 postburn weeks in 15 subjects by measuring the differential excretion of enterally administered lactulose and mannitol. The mean age and burn size of the patients were 32.7 +/- 3.6 years and 53.3% +/- 5.1% of the total body surface area, respectively. Ten healthy volunteers were also studied. The lactulose-mannitol excretion ratio was 0.159 +/- 0.017 for the patients and 0.017 +/- 0.003 for controls. The increased ratio did not correlate with burn size or postburn day. Patients who developed significant clinical infections during their first 2 postburn weeks had lactulose-mannitol ratios on postburn day 2 that were significantly higher than those of controls and patients who did not develop infections. This suggests a relationship between susceptibility to infection and early alterations in intestinal permeability.
LeVoyer
T
T
US Army Institute of Surgical Research, Fort Sam Houston, TX 78234-5012.
Cioffi
W G
WG
Pratt
L
L
Shippee
R
R
McManus
W F
WF
Mason
A D
AD
Pruitt
B A
BA
D000328:Adult; D002056:Burns / Q000150:complications / Q000378:metabolism*; D005260:Female; D006801:Humans; D007239:Infections / Q000150:complications; D007413:Intestinal Mucosa / Q000378:metabolism*; D007792:Lactulose / Q000493:pharmacokinetics; D008297:Male; D008353:Mannitol / Q000493:pharmacokinetics; D010539:Permeability
D008353:Mannitol; D007792:Lactulose