Intestinal Permeability in Critically Ill Patients

Abstract

The purpose of this study was to assess whether critically ill patients with either 24 h nothing per os (NPO) or 24 h enteral nutrition (EN) treatment have abnormalities in intestinal permeability. Nineteen critically ill patients admitted to the Taichung Veterans General Hospital intensive care unit and 10 normal subjects were studied. The lactulose/L-rhamnose differential sugar absorption test was used. A crossover design was applied. Patients were randomly divided into 2 groups and received both EN and NPO treatment in different sequence. After each treatment, test solution was given and 5 h urine was collected. There were no significant differences in percentage recovery of lactulose and rhamnose and lactulose/L-rhamnose ratio (L/R ratio) between feeding and NPO treatment. Results implied that either 24 h EN or 24 h NPO had no significant effect on intestine permeability. However, normal subjects had significantly higher percentage recovery of rhamnose and lower L/R ratio. Results also showed that there was no any relationship between severity of illness and intestinal permeability. Increased intestinal permeability occurred in the critically ill patients with a variety of diseases in the intensive care unit.