Intestinal Microcirculation: Changes in Sepsis and Effect of Vasoactive Manipulation
Multiple organ dysfunction syndrome (MODS) continues to be a source of excessive morbidity and mortality in the critically ill population . While the pathogenesis of MODS remains to be fully elucidated, a popular approach to explain its development is the ‘gut origin’ theory. This proposes that a variety of local and/or systemic insults result in depression of the intestine’s physiological function, specifically the loss of its protective barrier function . This leads to increased translocation, the passage of viable bacteria and/or endotoxin across the intestinal epithelium to mesenteric lymph nodes and portal blood . Such gut-derived bacteria or endotoxin could then trigger, exaggerate, and perpetuate the systemic inflammatory response that occurs in MODS. It is this concept that has prompted some to refer to the gut as the ‘motor’ of MODS .
KeywordsPlacebo Permeability Depression Dopamine Norepinephrine
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- 2.Livingstone DH, Mosenthal AC, Deitch EA (1995) Sepsis and multiple organ dysfunction syndrome: A clinical-mechanistic overview. New Horiz 3: 257–266Google Scholar
- 4.Meakins JL, Marshall JC (1986) The gastro-intestinal tract: the `motor’ of multiple organ failure. Arch Surg 121: 197–201Google Scholar
- 5.Donald D (1983) Splanchnic circulation. In: Shepherd JT, Abboud FM (eds) Handbook of physiology: The cardiovascular system, peripheral circulation and organ blood flow. Raven Press, Philadelphia, pp 219–240Google Scholar
- 17.Reed LL, Martin M, Mangiano R, Newson B, Kocka F, Barrett 1 (1994) Bacterial translocation following abdominal trauma in humans. Circ Shock 42: 1–6Google Scholar