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CPT Thomas LeVoyer, MC, USA; MAJ W. G. Cioffi, Jr, MC, USA; CPT Laura Pratt, MC, USA; MAJ Ronald Shippee, MC, USA; COL William F. McManus, MC, USA; A. D. Mason, Jr, MD; COL B. A. Pruitt, Jr, MC, USA

Arch Surg. 1992;127(1):26-30.

Abstract
• Alterations in intestinal permeability have been postulated to occur after thermal injury. We evaluated the status of intestinal permeability during the first 2 postburn weeks in 15 subjects by measuring the differential excretion of enterally administered lactulose and mannitol. The mean age and burn size of the patients were 32.7±3.6 years and 53.3%±5.1% of the total body surface area, respectively. Ten healthy volunteers were also studied. The lactulose-mannitol excretion ratio was 0.159±0.017 for the patients and 0.017±0.003 for controls. The increased ratio did not correlate with burn size or postburn day. Patients who developed significant clinical infections during their first 2 postburn weeks had lactulose-mannitol ratios on postburn day 2 that were significantly higher than those of controls and patients who did not develop infections. This suggests a relationship between susceptibility to infection and early alterations in intestinal permeability.

(Arch Surg. 1992;127:26-30)

Author Affiliations
From the US Army Institute of Surgical Research, Fort Sam Houston, Tex.

Footnotes
Accepted for publication September 8, 1991.

The views of the authors do not purport to reflect the positions of the Department of the Army and the Department of Defense.

Presented at the 11th Annual Meeting of the Surgical Infection Society, Fort Lauderdale, Fla, April 8, 1991.

Reprint requests to US Army Institute of Surgical Research, SGRD-USC-B, Fort Sam Houston, TX 78234-5012 (Dr Cioffi).

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