A prospective observational study of the effect of critical illness on ultrastructural and microscopic morphology of duodenal mucosa

Abstract

Objective: Disturbed intestinal barrier function due to ‘leaky’ tight junctions may cause secondary sepsis via paracellular translocation across the gut wall. Our objective was to describe the effects of critical illness on duodenal morphology and ultrastructure. Design, setting and participants: Prospective observational study of 12 mechanically ventilated critically ill patients in an intensive care unit and 15 control participants in an outpatient endoscopy suite. Intervention: We took six endoscopic biopsy samples of the duodenum from each participant for analysis by electron and light microscopy. Main outcome measures: Our primary outcome was tight junction morphology, examined with ele..