Increased gut permeability after multiple trauma

Gut permeability was studied in multiply injured patients with respect to the development of multiple organ failure (MOF). Two groups were defined according to MOF score (threshold 10 points) as to whether MOF developed (group 1; n = 11, four deaths) or did not (group 2; n = 21, no death). Gut perme...

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Published inBritish journal of surgery Vol. 81; no. 6; p. 850
Main Authors Pape, H C, Dwenger, A, Regel, G, Auf'm'Kolck, M, Gollub, F, Wisner, D, Sturm, J A, Tscherne, H
Format Journal Article
LanguageEnglish
Published England 01.06.1994
Subjects
Adult
Bilirubin - blood
Female
Humans
Intestinal Absorption - physiology
Lactulose - urine
Liver - metabolism
Male
Mannitol - urine
Middle Aged
Multiple Organ Failure - metabolism
Multiple Trauma - blood
Multiple Trauma - metabolism
Multiple Trauma - urine
Pancreatic Elastase - blood
Prospective Studies
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Summary:Gut permeability was studied in multiply injured patients with respect to the development of multiple organ failure (MOF). Two groups were defined according to MOF score (threshold 10 points) as to whether MOF developed (group 1; n = 11, four deaths) or did not (group 2; n = 21, no death). Gut permeability was determined from the ratio of urinary excretion of enterally administered lactulose and mannitol. Serum elastase concentrations were also determined. Mean(s.e.m.) gut permeability was abnormal during the entire study (day 1: group 1--5.1(2.1) versus group 2--10.6(4.1) (P not significant; P < 0.001 versus normal volunteers, 0.56(0.24)). An increase on days 3 and 5 correlated with serum elastase levels only in patients in group 1 (rs = 0.71, P < 0.01). Severe injury leads to increased intestinal permeability, which is related to a systemic inflammatory response.
ISSN:0007-1323
DOI:10.1002/bjs.1800810619