ABSTRACT
The pathological mechanisms underlying the development of multiple organ dysfunction in critically ill patients remain poorly understood. Although a large body of data supports the idea that the systemic inflammatory response syndrome (SIRS) and the multiple organ dysfunction syndrome (MODS) are causally related, the SIRS/MODS model is insufficient by itself to explain some common clinical observations. The frequent occurrence of gastrointestinal mucosal acidosis in critically ill patients is another observation that lends support to the idea that gut barrier dysfunction is important in the pathogenesis of MODS. Since the gastrointestinal tract contains huge numbers of microbes and large quantities of potentially toxic microbial products, it is attractive to hypothesize that leakage of bacteria or yeast or microbial toxins from the gut into the systemic compartment might contribute to systemic illness, even in the absence of a gross disruption of mural integrity.
