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Additive effects of thermal injury and infection on gut permeability
C M Ryan1, S H Bailey, E A Carter
1Surgical Service, Massachusetts General Hospital, Boston.
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.