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

• Published in: Intensive care medicine 2004, Vol.30 (1), p.162-166
• Main Authors: VENKATESH, Balasubramanian, GOUGH, Jenny, RALSTON, David R, MULLER, Michael, PEGG, Stuart
• Format: Article
• Language: English
• Subjects: Abnormalities; Adolescent; Adult; alpha 1-Antitrypsin - analysis; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Proteins - metabolism; Burns; Burns - classification; Burns - complications; Burns - therapy; Burns and scalds; Critical Illness; Critically ill; Edema; Feces - chemistry; Female; Fluid Therapy - methods; Gastrointestinal system; Health aspects; Humans; Intensive care; Intensive care medicine; Ischemia; Linear Models; Male; Medical sciences; Middle Aged; Nutrition Assessment; Patients; Prospective Studies; Protein-Losing Enteropathies - classification; Protein-Losing Enteropathies - diagnosis; Protein-Losing Enteropathies - etiology; Protein-Losing Enteropathies - metabolism; Proteins; Resuscitation - methods; Risk factors; Serum Albumin - metabolism; Severity of Illness Index; Time Factors
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/s00134-003-2050-2

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. 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 alpha1-antitrypsin (FA-1-AT) concentrations. Serial measurements of serum protein and albumin concentrations were performed. 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 (R2=0.40). Protein losing enteropathy was demonstrable in patients with major burns. The magnitude of this phenomenon appears to be proportional to the burns size.