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Bacterial translocation: clinical implications and prevention.
Douglass K Macintire1, Ted L Bellhorn
1Department of Small Animal Surgery and Medicine, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA. macindk@vetmed.auburn.edu
The Veterinary Clinics of North America. Small Animal Practice
|October 17, 2002
Summary
Bacterial translocation (BT) contributes to systemic inflammatory response syndrome (SIRS) and organ dysfunction in critical illness. Early resuscitation and gut-protective strategies may improve survival in patients with bacterial translocation.
Area of Science:
- Critical care medicine
- Gastroenterology
- Immunology
Background:
- Bacterial translocation (BT) is observed in various critical conditions, including hemorrhagic shock, trauma, burns, cirrhosis, pancreatitis, and bacterial overgrowth.
- The process involves bacteria and endotoxins moving from the gut to lymph nodes, triggering a systemic inflammatory response syndrome (SIRS).
- SIRS involves the release of inflammatory mediators, potentially leading to irreversible multiple organ dysfunction.
Purpose of the Study:
- To review the mechanisms and implications of bacterial translocation in critical illness.
- To discuss therapeutic strategies for managing conditions associated with BT.
Main Methods:
- Review of existing literature on bacterial translocation and SIRS.
- Analysis of experimental animal models and clinical observations.
Main Results:
- BT is a significant factor in the pathogenesis of SIRS and organ failure in critical illness.
- Splanchnic hypoperfusion is closely linked to BT.
Conclusions:
- Restoring tissue perfusion and removing septic foci are crucial therapeutic interventions.
- Gut protectants, promotility agents, antioxidants, and immune-enhancing diets show potential for improving survival in critically ill patients with BT.