Trauma, shock and sepsis can induce marked changes in gastrointestinal homeostasis including abnormal colonization and impaired intestinal epithelial barrier function. Intestinal mucosal injury can activate the gut and the gut-associated lymphatic tissue to produce cytokines and other inflammatory mediators that may contribute to distant systemic inflammation and organ dysfunction. Hence, gut dysfunction appears not only to be capable of promoting hyperinflammation and multiorgan dysfunction but also to be a substantial target for prevention. This review summarizes new insights into the role of the gastrointestinal tract in the genesis of systemic inflammation and organ dysfunction and discusses therapeutic endpoints for resuscitation of the hepato-splanchnic region.

        Key words: shock – sepsis – multiple organ failure – gut dysfunction – splanchnic blood flow