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Clinical Chemistry 38: 343-345, 1992;
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Clinical Chemistry, Vol 38, 343-345, Copyright © 1992 by American Association for Clinical Chemistry

Simultaneous determination of lactulose and mannitol in urine of burn patients by gas-liquid chromatography

RL Shippee, AA Johnson, WG Cioffi, J Lasko, TE LeVoyer and BS Jordan
U.S. Army Institute of Surgical Research, Fort Sam Houston, TX 78234- 5012.

Ratios of lactulose/mannitol excretion in urine have been used to assess the extent of intestinal permeability in various disease and trauma conditions. Reported studies have used this technique to correlate altered gastrointestinal mucosal permeability to translocation of bacteria and endotoxin, leading to occult sepsis in burn patients. Enzymatic methods of analysis for urine concentrations of mannitol and lactulose were used in these studies. We have found that urine from patients with severe burns frequently contains compounds that interfere with the enzymatic methods. We describe using gas-liquid chromatography to determine mannitol and lactulose simultaneously in the urine of burn patients. To avoid the multiple peaks for the anomeric forms of the reducing sugars during precolumn trimethylsilyl derivatization, we converted the sugars to oximes before the silylation step. The method gave good recoveries of mannitol and lactulose added to burn patients' urine samples. Unlike the enzymatic methods, gas-liquid chromatography eliminates the effect of interfering compounds and allows for the simultaneous determination of both sugars in urine samples.




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Copyright © 1992 by the American Association for Clinical Chemistry.