Protein losing enteropathy in critically ill adult patients with burns: a preliminary report.
OBJECTIVE
Few data have been published regarding protein losing enteropathy in adult patients with burns. This study characterised the presence of protein-losing enteropathy in adults with burns and examined the relationship between the magnitude of burn size and the severity of protein loss.


METHODS
Twenty adult patients with burns (BSA 31+/-25%, range 2-80%) were studied. Fluid resuscitation was based on the Parkland's formula. Protein loss into the gastrointestinal tract was measured using faecal alpha1-antitrypsin (FA-1-AT) concentrations. Serial measurements of serum protein and albumin concentrations were performed.


RESULTS
Fourteen patients demonstrated elevations in FA-1-AT levels. The mean peak FA-1-AT level was 3.6+/-4.2 mg/g dry weight of stool. Two patients demonstrated elevated FA-1-AT excretion 1.5 months and 3 months after the burns. There was a good correlation between burn size and FA-1-AT excretion (R2=0.40).


CONCLUSIONS
Protein losing enteropathy was demonstrable in patients with major burns. The magnitude of this phenomenon appears to be proportional to the burns size.
Venkatesh
Balasubramanian
B
Intensive Care Unit, Princess Alexandra Hospital, University of Queensland, Australia, bala_venkatesh@health.qld.gov.au
Gough
Jenny
J
Ralston
David R
DR
Muller
Michael
M
Pegg
Stuart
S
D000293:Adolescent; D000328:Adult; D001798:Blood Proteins / Q000378:metabolism; D002056:Burns / Q000145:classification / Q000150:complications* / Q000628:therapy; D016638:Critical Illness; D005243:Feces / Q000737:chemistry*; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D011446:Prospective Studies; D011504:Protein-Losing Enteropathies / Q000145:classification / Q000175:diagnosis* / Q000209:etiology* / Q000378:metabolism; D012151:Resuscitation / Q000379:methods; D012709:Serum Albumin / Q000378:metabolism; D012720:Severity of Illness Index; D013997:Time Factors; D000515:alpha 1-Antitrypsin / Q000032:analysis*
D001798:Blood Proteins; D012709:Serum Albumin; D000515:alpha 1-Antitrypsin