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The gastrointestinal tract as a barrier in sepsis
B J Rowlands1, C V Soong, K R Gardiner
1Section of Surgery, Queen's Medical Centre, University Hospital, Nottingham, UK.
British Medical Bulletin
|March 1, 2000
Summary
The gastrointestinal tract is vital for digestion and acts as a barrier. When compromised during sepsis, it can lead to organ dysfunction and death, necessitating supportive care and source control.
Area of Science:
- Gastroenterology
- Critical Care Medicine
- Immunology
Background:
- The gastrointestinal (GI) tract is metabolically active, essential for digestion and nutrient absorption.
- In healthy individuals, the GI tract functions as a critical barrier against pathogens and antigens.
- Compromise of the GI mucosal barrier during sepsis allows microbial translocation, leading to systemic inflammation.
Purpose of the Study:
- To highlight the critical role of the gastrointestinal tract in health and disease.
- To discuss the consequences of GI barrier dysfunction in critical illness, specifically sepsis.
- To outline therapeutic strategies for supporting GI function in intensive care unit (ICU) patients.
Main Methods:
- Review of the physiological functions of the GI tract.
- Analysis of the pathophysiology of GI barrier compromise in sepsis.
- Discussion of current therapeutic approaches in critical care.
Main Results:
- Sepsis-induced GI barrier dysfunction facilitates the entry of toxins and microorganisms into circulation.
- This translocation contributes to systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS).
- Deterioration and mortality in ICU patients are linked to these systemic effects.
Conclusions:
- Maintaining GI tract structure and function is crucial for critically ill patients.
- Therapeutic strategies should focus on supporting immune function and GI integrity.
- Ablation of the septic or necrotic source is paramount for successful treatment outcomes.