Review article: bacterial translocation in the critically ill - evidence and methods of prevention
Autor: | M. Gatt, John MacFie, Bala S. Reddy |
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Rok vydání: | 2006 |
Předmět: |
medicine.medical_specialty
Hepatology business.industry medicine.drug_class Antibiotics Gastroenterology Psychological intervention Chromosomal translocation medicine.disease Surgery Review article Systemic inflammatory response syndrome Sepsis Intensive care medicine Pharmacology (medical) Intensive care medicine business Barrier function |
Zdroj: | Alimentary Pharmacology & Therapeutics. 25:741-757 |
ISSN: | 1365-2036 0269-2813 |
Popis: | Summary Background Delayed sepsis, systemic inflammatory response syndrome (SIRS) and multiorgan failure remain major causes of morbidity and mortality on intensive care units. One factor thought to be important in the aetiology of SIRS is failure of the intestinal barrier resulting in bacterial translocation and subsequent sepsis. Aim This review summarizes the current knowledge about bacterial translocation and methods to prevent it. Methods Relevant studies during 1966–2006 were identified from a literature search. Factors, which detrimentally affect intestinal barrier function, are discussed, as are methods that may attenuate bacterial translocation in the critically ill patient. Results Methodological problems in confirming bacterial translocation have restricted investigations to patients undergoing laparotomy. There are only limited data available relating to specific interventions that might preserve intestinal barrier function or limit bacterial translocation in the intensive care setting. These can be categorized broadly into pre-epithelial, epithelial and post-epithelial interventions. Conclusions A better understanding of factors that influence translocation could result in the implementation of interventions which contribute to improved patient outcomes. Glutamine supplementation, targeted nutritional intervention, maintaining splanchnic flow, the judicious use of antibiotics and directed selective gut decontamination regimens hold some promise of limiting bacterial translocation. Further research is required. |
Databáze: | OpenAIRE |
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