It has been noted by a number of investigators that the irreversibility of shock probably results from the escape of endotoxin from the lumen of the small bowel into the circulation. In order to test this concept, studies in dogs with isolated jejunal loops were done to compare the absorption of xylose, a normally absorbed sugar, with that of inulin, a polysaccharide not normally absorbed. Experiments were performed in the normal animal, as well as during reversible and irreversible shock. The results indicate that in the presence of severe hypotension, permeation of the mucosa by inulin (molecular weight, 5,000) is increased. This is associated with a decreased absorption of xylose.
Ambromovage AM, Shah U, Howard JM. Xylose and Inulin Absorption: From the Small Intestine of Dogs Following Endotoxin Shock. Arch Surg. 1971;102(5):496–500. doi:https://doi.org/10.1001/archsurg.1971.01350050062018
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: