ABSTRACT
Gut failure is increasingly recognised as a problem in critically ill patients. Being highly vascular, the gastrointestinal (GI) tract is prone to bleeding. Risk factors include:
n stress responses increasing gastric acid secretion; n impaired gut perfusion; n inflammatory responses impairing vascular endothelium function, which
releases most extrinsic clotting factors; n lack of enteral feeding; n anticoagulation therapy, especially with thrombolytic therapy for acute
coronary syndrome or pulmonary embolism; n impaired liver function – intrinsic clotting factors are produced by the liver;
alcoholic liver disease poses an especially high risk.
