Protein losing enteropathy in critically ill adult patients with burns: a preliminary report

Abstract

Objective

Few data have been published regarding protein losing enteropathy in adult patients with burns. This study characterised the presence of protein-losing enteropathy in adults with burns and examined the relationship between the magnitude of burn size and the severity of protein loss.

Methods

Twenty adult patients with burns (BSA 31±25%, range 2–80%) were studied. Fluid resuscitation was based on the Parkland’s formula. Protein loss into the gastrointestinal tract was measured using faecal α1-antitrypsin (FA-1-AT) concentrations. Serial measurements of serum protein and albumin concentrations were performed.

Results

Fourteen patients demonstrated elevations in FA-1-AT levels. The mean peak FA-1-AT level was 3.6±4.2 mg/g dry weight of stool. Two patients demonstrated elevated FA-1-AT excretion 1.5 months and 3 months after the burns. There was a good correlation between burn size and FA-1-AT excretion (R 2=0.40).

Conclusions

Protein losing enteropathy was demonstrable in patients with major burns. The magnitude of this phenomenon appears to be proportional to the burns size.

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Fig. 1

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Acknowledgements

These data were presented as a free paper in the Annual Scientific Meeting of the Australian New Zealand Burn Association in Hobart in 2001. The study was supported through a grant from the Royal Brisbane Hospital Research Foundation. We also acknowledge the nursing staff of the Burns and Intensive Care Units for their assistance with the study.

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Correspondence to Balasubramanian Venkatesh.

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Venkatesh, B., Gough, J., Ralston, D.R. et al. Protein losing enteropathy in critically ill adult patients with burns: a preliminary report. Intensive Care Med 30, 162–166 (2004). https://doi.org/10.1007/s00134-003-2050-2

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Keywords

  • Burn
  • Critical illness
  • Gut
  • Mucosa
  • Protein losing enteropathy