The gut as the motor of multiple organ dysfunction in critical illness

NJ Klingensmith, CM Coopersmith - Critical care clinics, 2016 - criticalcare.theclinics.com
The gut has been hypothesized to be the motor of multiple organ dysfunction syndrome
(MODS) for the past quarter century. 1–3 Whereas initial theories of gut and critical illness
suggested that hyperpermeability resulted in bacterial translocation into the systemic
circulation, the reality is significantly more complex than was hypothesized originally. All
elements of the gut—the epithelium, the immune system, and the microbiome—are impacted
by critical illness and can, in turn, propagate a pathologic host