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Alterations in intestinal permeability after thermal injury
T LeVoyer1, W G Cioffi, L Pratt
1US Army Institute of Surgical Research, Fort Sam Houston, TX 78234-5012.
Archives of Surgery (Chicago, Ill. : 1960)
|January 11, 1992
Summary
Severe burns increase intestinal permeability, measured by the lactulose-mannitol ratio. This heightened gut permeability, particularly by postburn day 2, correlates with infection susceptibility in burn patients.
Area of Science:
- Gastroenterology
- Trauma Surgery
- Immunology
Background:
- Thermal injury can significantly impact gastrointestinal function.
- Intestinal permeability alterations are a suspected complication following severe burns.
Purpose of the Study:
- To evaluate changes in intestinal permeability during the initial two weeks post-thermal injury.
- To investigate the relationship between intestinal permeability and infection risk in burn patients.
Main Methods:
- Assessed intestinal permeability using the lactulose-mannitol excretion ratio in 15 burn patients and 10 healthy controls.
- Measured differential excretion of orally administered lactulose and mannitol.
- Analyzed data for correlations with burn size, postburn day, and infection development.
Main Results:
- Burn patients exhibited a significantly higher lactulose-mannitol ratio (0.159) compared to controls (0.017).
- Increased intestinal permeability did not correlate with burn size or postburn day.
- Higher lactulose-mannitol ratios on postburn day 2 were observed in patients who developed infections.
Conclusions:
- Severe thermal injury leads to early and sustained increases in intestinal permeability.
- Elevated intestinal permeability in the early postburn period is associated with an increased susceptibility to clinical infections.