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Intestinal permeability in the critically ill.

C E Harris1, R D Griffiths, N Freestone

  • 1Intensive Care Unit, Whiston Hospital, Prescot, Merseyside, UK.

Intensive Care Medicine
|January 1, 1992
PubMed
Summary
This summary is machine-generated.

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Critically ill patients show increased intestinal permeability, measured by the lactulose/mannitol ratio. This heightened permeability is not directly linked to disease severity or sepsis in intensive care unit (ICU) patients.

Area of Science:

  • Gastroenterology
  • Critical Care Medicine
  • Physiology

Background:

  • Intestinal permeability is a key aspect of intestinal epithelial barrier function.
  • Alterations in this barrier are observed in various disease states.
  • Understanding permeability changes in critically ill patients is crucial.

Purpose of the Study:

  • To evaluate the extent of intestinal permeability derangement in critically ill patients.
  • To explore the correlation between intestinal permeability and markers of disease severity and sepsis.

Main Methods:

  • A differential sugar absorption test using lactulose and mannitol was employed.
  • The lactulose/mannitol (L/M) ratio was calculated to assess intestinal permeability.
  • Patients admitted to the intensive care unit (ICU) were studied, with daily recording of illness severity and sepsis markers.

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Main Results:

  • The L/M ratio was significantly elevated in critically ill patients (median 0.98) compared to healthy controls (median 0.008).
  • No significant relationship was found between the L/M ratio and the severity of illness or sepsis.
  • Intestinal permeability was found to be increased in the general ICU population, not exclusively in septic patients.

Conclusions:

  • Critically ill patients exhibit increased intestinal permeability.
  • This increase is not solely attributable to sepsis or disease severity.
  • Further research is warranted to elucidate the multifactorial influences on intestinal permeability in the ICU setting.