Why and How to Protect the Gastrointestinal Tract in Critically Ill Patients

Overview

Trauma, shock and sepsis can induce marked changes in gastrointestinal homeostasis including abnormal colonizationand impaired intestinal epithelial barrier function. Intestinal mucosal injury can activate the gut and the gut-associatedlymphatic tissue to produce cytokines and other inflammatory mediators that may contribute to distant systemic inflammationand organ dysfunction. Hence, gut dysfunction appears not only to be capable of promoting hyperinflammation andmultiorgan dysfunction but also to be a substantial target for prevention. This review summarizes new insights into the roleof the gastrointestinal tract in the genesis of systemic inflammation and organ dysfunction and discusses therapeuticendpoints for resuscitation of the hepato-splanchnic region.

Key words:
shock – sepsis – multiple organ failure – gut dysfunction – splanchnic blood flow