| Abstrakt: |
The importance of the gastro-intestinal system has been neglected for a long time in critically ill patients. Fine and advanced contemporary hypotheses on the role of the gut as the main driver in critical illness, or an undrained abscess in multiple organ failure, or the central organ of surgical stress, however, have changed this view fundamentally. Considering that the gut with its intestinal mucosa, mesenteric lymph nodes and the associated liver is the largest immunologic system of the human organism, its importance in critically ill has become obvious. Acute intraabdominal diseases, sepsis, trauma, mechanical ventilation, drugs or lack of enteral feeding may lead to the clinical picture of mechanical or paralytic ileus or to complete gut failure. On the other hand, a poorly perfused or paralytic gut may induce or enhance sepsis or septic shock, probably via microbial translocation from the intestinal lumen over an altered intestinal barrier. Furthermore, the abdominal compartment syndrome defined by a sustained intraabdominal hypertension results in poor cardiac output, oliguria and atelectasis in the lung associated with impaired respiratory mechanics. [ABSTRACT FROM AUTHOR] |
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