ABSTRACT
The mucosa of the human intestine covers an estimated 300 m2 and provides a critical
barrier against a reservoir of over 400 bacterial strains. In addition to digestion and nutri-
ent absorption, the gut mucosa also presents an active immunologic interface, which plays
a key role in host health. Reliable clinical variables to monitor the health of the gut
mucosal barrier (GMB) currently do not exist. Consequently, current therapy aims at
supporting the GMB’s three major constituents: mucosal integrity, immunocompetence,
and the balance of commensal microflora. Of practical concern to the intensivist are
preservation of GMB, maintenance of normal gut ecology, awareness of the risk of
antibiotic-associated (Clostridium difficile) colitis, optimization of nutritional support,
and minimization of the risk of stress ulceration and bleeding.
