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March 1994

Additive Effects of Thermal Injury and Infection on Gut Permeability

Author Affiliations

From the Surgical Services (Drs Ryan and Tompkins and Mr Bailey), Children's Services (Dr Carter), and Biostatistics Center (Dr Schoenfeld), Massachusetts General Hospital; and Departments of Surgery (Drs Ryan and Tompkins and Mr Bailey), Pediatrics (Dr Carter), and Medicine (Dr Schoenfeld), Harvard Medical School, Boston.

Arch Surg. 1994;129(3):325-328. doi:10.1001/archsurg.1994.01420270103021

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.(Arch Surg. 1994;129:325-328)