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Additive Effects of Thermal Injury and Infection on Gut Permeability

Colleen M. Ryan, MD; Stephen H. Bailey; Edward A. Carter, PhD; David A. Schoenfeld, PhD; Ronald G. Tompkins, MD, ScD
Arch Surg. 1994;129(3):325-328. doi:10.1001/archsurg.1994.01420270103021.
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Objective:  To determine the effects of burn size and burn wound infection on gut permeability to the macromolecule polyethylene glycol 3350 (PEG 3350; molecular weight, 3350 d).

Design:  Randomized, controlled study using 36 male Sprague-Dawley rats.

Setting:  Hospital research laboratory.

Interventions:  Animals received scald burns to 0%, 20%, or 35% of their total body surface area. Half of the animals in each group were infected with Pseudomonas aeruginosa.

Main Outcome Measures:  Gut permeability was measured using the intestinal absorption and renal excretion of enterally administered PEG 3350 and mannitol (molecular weight, 182 d).

Results:  There were dramatic increases in PEG 3350 excretion and in the PEG 3350/mannitol ratios (P=.0001 in both instances) that were seen in relation to burn size. Significant increases in PEG 3350 excretion and in the PEG 3350/mannitol ratios (P=.017 and P=.045, respectively) were also seen in animals in which infection was present. This was in addition to the effects of burn size already noted.

Conclusions:  A direct relationship between gut permeability and the extent of burn injury was found, which is consistent with the results from a previous study in humans. In addition, this study found that further separate increases in gut permeability occur in the presence of P aeruginosa in burn wound infections.(Arch Surg. 1994;129:325-328)


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