Alterations in Intestinal Permeability After Thermal Injury

CPT Thomas LeVoyer, MC, USA; MAJ W. G. Cioffi Jr, MC, USA; CPT Laura Pratt, MC, USA; MAJ Ronald Shippee, MC, USA; COL William F. McManus, MC, USA; A. D. Mason Jr, MD; COL B. A. Pruitt Jr, MC, USA
Arch Surg. 1992;127(1):26-30. doi:10.1001/archsurg.1992.01420010032005.
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• 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.

(Arch Surg. 1992;127:26-30)


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