Does fluid loading influence measurements of intestinal permeability?
BACKGROUND
Urinary recovery of enterally administered probes is used as a clinical test of intestinal mucosal permeability. Recently, evidence has been provided that the recovery of some but not all sugar probes is dependent on the amount of diuresis and renal function. The aim of this study was to assess the effect of fluid loading on the urinary recovery of sugar probes in healthy volunteers.


METHODS
In a cross-over study, 10 healthy volunteers ingested 100 ml of a solution containing 0.2 g of 3-O-methyl-D-glucose (3-OMG), 0.5 g of D-xylose, 1.0 g of L-rhamnose, and 5.0 g of lactulose on two different days. The volunteers were randomized to receive either 2 litres of Ringer acetate or no fluid during the following 3 hours. The sugar concentrations were measured in 5-hour urine samples period.


RESULTS
Fluid loading increased urine production and urinary recovery of xylose. Fluid loading did not influence the urinary recovery of 3-OMG, L-rhamnose, or lactulose. Neither the lactulose/rhamnose ratio nor the 3-OMG/rhamnose ratio changed.


CONCLUSIONS
Fluid loading increases mediated carbohydrate transport but not the lactulose/rhamnose ratio, after oral sugar administration in healthy volunteers. It remains to be determined whether sugar probes are handled differently in response to fluids in patients with organ dysfunctions.
Department of Anesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland. ilkka.parviainen@kuh.fi
Ilkka
I
Parviainen
Jukka
J
Takala
Stephan M
SM
Jakob
D000328:Adult; D002241:Carbohydrates / Q000652:urine; D018592:Cross-Over Studies; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007413:Intestinal Mucosa / Q000187:drug effects* / Q000378:metabolism; D007552:Isotonic Solutions / Q000494:pharmacology*; D008297:Male; D010539:Permeability / Q000187:drug effects; D014994:Xylose / Q000652:urine*
D002241:Carbohydrates; D007552:Isotonic Solutions; C028570:Ringer's acetate; D014994:Xylose