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 d efined 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 e xcretion of enterally administered lactulose and mannitol. Serum elast ase 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 g roup 2 10.6(4.1) (P not significant; P < 0.001 versus normal volunteer s, 0.56(0.24)). An increase on days 3 and 5 correlated with serum elas tase levels only in patients in group 1 (r(s) = 0.71, P < 0.01). Sever e injury leads to increased intestinal permeability, which is related to a systemic inflammatory response.