The role of the gastrointestinal tract in postinjury multiple organ failure.

Abstract:

:Despite intensive investigation, the pathogenesis of postinjury multiple organ failure (MOF) remains elusive. Laboratory and clinical research strongly implicate that the gastrointestinal tract plays a pivotal role. Shock with resulting gut hypoperfusion appears to be one important inciting event. While early studies persuasively focused attention on bacterial translocation as a unifying mechanism to explain early and late sepsis syndromes that characterize postinjury MOF, subsequent studies suggest that other gut-specific mechanisms are operational. Based on our Trauma Research Center observations and those of others, we conclude that: 1) bacterial translocation may contribute to early refractory shock; 2) for patients who survive shock, the reperfused gut appears to be a source of proinflammatory mediators that may amplify the early systemic inflammatory response syndrome; and 3) early gut hypoperfusion sets the stage for progressive gut dysfunction such that the gut becomes a reservoir for pathogens and toxins that contribute to late MOF.

journal_name

Am J Surg

authors

Moore FA

doi

10.1016/s0002-9610(99)00231-7

subject

Has Abstract

pub_date

1999-12-01 00:00:00

pages

449-53

issue

6

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(99)00231-7

journal_volume

178

pub_type

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