[Microbial translocation from the gastrointestinal tract--pathophysiologic phenomenon or catalyst for multiple organ...

The constant passage of intestinal microorganisms and endotoxin into the gut associated immune system is an important physiological process for its optimal function. Under the conditions of disturbed microflora homeostasis, impaired mucosal permeability, and immunocompromisation, translocation is pathologically increased both in the animal experiment and in man. The clinical relevance of increased translocation is not yet definitively established. But from lots of evidence it seems that in the immunocompromised critically ill with systemic inflammatory response syndrome/sepsis, microbial translocation plays an important role for the eventual outcome towards multiple-organ-failure. Our therapeutic efforts have to concentrate on protection of the gut mucosa by maintaining adequate splanchnic blood flow and providing early enteral nutrition.