TY - CHAP M1 - Book, Section TI - Gastrointestinal Failure A1 - Rosenthal, Martin D. A1 - Kozar, Rosemary A. A1 - Moore, Frederick A. A2 - Moore, Ernest E. A2 - Feliciano, David V. A2 - Mattox, Kenneth L. PY - 2017 T2 - Trauma, 8e AB - For patients who survive the first 48 hours of intensive care, multiple organ failure (MOF) is the leading cause of death among patients in the intensive care unit (ICU) (see Chapter 61). Several lines of clinical evidence convincingly link gut injury and subsequent dysfunction to MOF.1 First, patients who experience persistent gut hypoperfusion after resuscitation are at high risk for abdominal compartment syndrome (ACS), which can lead to early MOF, and even death.2,3 Second, epidemiologic studies have consistently shown that the normally sterile proximal gut becomes heavily colonized with a variety of organisms. These same organisms have been identified to be pathogens that cause late nosocomial infections after the ischemia–reperfusion insult weakens the gut barriers.4,5,6,7,8,9,10,11,12 Third, gut-specific therapies (selective gut decontamination, early enteral nutrition, and most recently immune-enhancing enteral diets [IEDs]) have been shown to reduce these nosocomial infections.13,14,15,16,17,18,19 The purpose of this chapter will be to first provide a brief overview of why critically injured trauma patients develop gut dysfunction and how gut dysfunction contributes to overall morbidity and mortality. The discussion will then focus on the pathogenesis and clinical monitoring of specific gut dysfunctions. Based on this information, potential therapeutic strategies to prevent and/or treat gut dysfunction to enhance patient outcome will be discussed. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesssurgery.mhmedical.com/content.aspx?aid=1141192387 ER -