Post-injury multiple organ failure: The role of the gut

Heitham T. Hassoun, Bruce C. Kone, David W. Mercer, Frank G. Moody, Norman W. Weisbrodt, Frederick A. Moore

Research output: Contribution to journalArticle

Abstract

Despite intensive investigation, the pathogenesis of post-injury multiple organ failure (MOF) remains elusive. Laboratory and clinical research strongly suggests that the gastrointestinal tract (i.e., the gut) plays a pivotal pathogenic role. Since its inception in 1988, the Trauma Research Center (TRC) at the University of Texas-Houston Medical School (UTHMS) has focused its efforts on elucidating the role of the gut in post-injury MOF. On the basis of our observations and those of others, we believe that 1) shock with resulting gut hypoperfusion is an important inciting event, 2) the reperfused gut is a source of proinflammatory mediators that can amplify the early systemic inflammatory response syndrome (SIRS) and thus contribute to early MOF, 3) early gut hypoperfusion causes an ileus in both the stomach and small bowel that sets the stage for progressive gut dysfunction so that the proximal gut becomes a reservoir for pathogens and toxins that contribute to late sepsis-associated MOF, and 4) late infections cause further worsening of this gut dysfunction. Thus, the gut can be both an instigator and a victim of MOF. The purpose of this article is to provide the rationale behind these beliefs and to provide a brief overview of the ongoing research projects in the TRC at UTHMS.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalShock
Volume15
Issue number1
DOIs
StatePublished - Jan 2001

Keywords

  • Bacterial translocation
  • Gastric alkalinization
  • Gut dysfunction
  • Gut hypoperfusion
  • Ileus
  • Multiple organ failure
  • SIRS
  • Shock

ASJC Scopus subject areas

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

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  • Cite this

    Hassoun, H. T., Kone, B. C., Mercer, D. W., Moody, F. G., Weisbrodt, N. W., & Moore, F. A. (2001). Post-injury multiple organ failure: The role of the gut. Shock, 15(1), 1-10. https://doi.org/10.1097/00024382-200115010-00001