THE RELATIONSHIP BETWEEN GUT-DERIVED BACTERIA AND THE DEVELOPMENT OF THE MULTIPLE ORGAN DYSFUNCTION SYNDROME

Abnormal colonisation, infections of gut origin and bacterial transloc ation an all signs of gut failure that have been hypothesised as being implicated in the pathogenesis of the multiple organ dysfunction synd rome (MODS). We have summarised published experimental and clinical st udies that have tried to correlate the occurrence or prevention of the se phenomena with the development of MODS. We conclude that in some pa tients loss of intestinal barrier function or the onset of infection p recedes the development of MODS. In other patients, however, this rela tionship is not so clear and it seems that these are epiphenoma of cri tical illness and may reflect a failure of the host's immune and mecha nical defence systems. The causal relationship between these phenomena and the development of MODS is complex and needs further clarificatio n.