Journal ArticleDOI
The Role of Intestinal Barrier Failure and Bacterial Translocation in the Development of Systemic Infection and Multiple Organ Failure
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TLDR
Evaluation of intestinal function has been limited largely to monitoring gastric pH and intestinal motility, but there has been a resurgence of interest in the role of intestinal barrier failures in the development of systemic infection and multiple organ failure in the critically ill or injured patient.Abstract:
Traditionally, evaluation of intestinal function has been limited largely to monitoring gastric pH and intestinal motility. This clinical approach has led clinicians to equate normal intestinal motility with normal intestinal function and to assume that if stress-induced gastric bleeding can be prevented, all will be well. However, it is becoming increasingly clear that the gastrointestinal tract is not a passive organ and that intestinal dysfunction is not limited to ileus and upper gastrointestinal bleeding. Instead, the gastrointestinal tract is recognized as having important endocrine, metabolic, immunologic, and barrier functions, as well as its traditional role in nutrient absorption. Over the last 5 years, there has been a resurgence of interest in the role of intestinal barrier failure in the development of systemic infection and multiple organ failure in the critically ill or injured patient.read more
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Multiple organ failure. Pathophysiology and potential future therapy.
TL;DR: The goals of this review are to integrate the vast amount of new information on the basic biology of MOF and to focus special attention on the potential therapeutic consequences of these recent advances in the authors' understanding of this complex and perplexing syndrome.
Journal ArticleDOI
Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trial
Marc G. Besselink,Hjalmar C. van Santvoort,Erik Buskens,Erik Buskens,Marja A. Boermeester,Harry van Goor,Harro M. Timmerman,Vincent B. Nieuwenhuijs,Thomas L. Bollen,Bert van Ramshorst,Ben J.M. Witteman,Camiel Rosman,Rutger J. Ploeg,Menno A. Brink,Alexander F. Schaapherder,Cornelis H. C. Dejong,Peter J. Wahab,Cees J. H. M. van Laarhoven,Erwin van der Harst,Casper H.J. van Eijck,Miguel A. Cuesta,Louis M. A. Akkermans,Hein G. Gooszen +22 more
TL;DR: In patients with predicted severe acute pancreatitis, probiotic prophylaxis with this combination of probiotic strains did not reduce the risk of infectious complications and was associated with an increased risk of mortality.
Journal ArticleDOI
Perioperative Plasma Volume Expansion Reduces the Incidence of Gut Mucosal Hypoperfusion During Cardiac Surgery
TL;DR: Perioperative plasma volume expansion with colloid during cardiac surgery, guided by esophageal Doppler measurement of cardiac stroke volume, reduced the incidence of gut mucosal hypoperfusion and this group of patients also had an improved outcome when compared with controls.
Journal Article
Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trial. Commentary
Juhani Sand,Isto Nordback,Marc G. Besselink,Hjalmar C. van Santvoort,Erik Buskens,Marja A. Boermeester,Harry van Goor,Harro M. Timmerman,Vincent B. Nieuwenhuijs,Thomas L. Bollen,Bert van Ramshorst,Ben J.M. Witteman,Camiel Rosman,Rutger J. Ploeg,Menno A. Blink,Alexander F. Schaapherder,Cornelis H. C. Dejong,Peter J. Wahab,Ceesj H. M. Van Laarhoven,Erwin van der Harst,Casper H.J. van Eijck,Miguel A. Cuesta,Louis M. A. Akkermans,Hein G. Gooszen +23 more
TL;DR: In this article, the effects of probiotic prophylaxis in patients with predicted severe acute pancreatitis were evaluated in a multicentre randomised, double-blind, placebo-controlled trial.
References
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Journal ArticleDOI
The gut origin septic states in blunt multiple trauma (ISS = 40) in the ICU.
John R. Border,James M. Hassett,John Laduca,Roger Seibel,Steven M. Steinberg,Barbara Mills,Patricia Losi,Donna O. Border +7 more
TL;DR: The association between support elements and the magnitude of the septic state (SSS) and its bacteriologic manifestations (bacti. log) in 66 patients with blunt multiple trauma over 1649 days have been studied restrospectively.
Journal ArticleDOI
Infection in the compromised host.
TL;DR: In this article the local and systemic antibacterial defense systems have been reviewed and it is shown that by manipulating the complex interrelations between the host and the indigenous bacterial flora, it may be possible to prevent the development of opportunistic infections originating from the gastrointestinal tract.