Whole gut washout for severe sepsis: Review of technique and preliminary results

Background. The purpose of this study was to determine the safety and feasibility of whole gut washout for severe sepsis in human beings. Methods. High-volume polyethylene glycol-3500 was administered to patients with severe sepsis. Body temperature, white blood cell count, and ventilatory indexes were recorded 24 hours before and 24 hours after whole gut washout. Results. A significant decrease in febrile response was observed after gut washout with polyethylene glycol. Improvements in PaO2, positive end-expiratory pressure, and peak airway pressure were observed. The washout was well tolerated in all but one patient. Conclusions. High-volume whole gut washout for severe sepsis appears safe in critically ill patients and may offer some promise in reducing enterogenic inflammation after catabolic stress.