Gastrointestinal Tract in Clinical Illness: the First Who Suffers, and the Last Who Recieves the Attention

V.A. Mazurok1, A.S. Golovkin1, A.E. Bautin1, I.I. Gorelov1, V.L. Belikov2, О. Slivin3

1 FGBI «SZFMITS named by V.A. Almazov» Ministry of Health, St.-Petersburg

2 FKUZ «Ministry of Emergency Situations Ministry of Internal Affairs of Russia in St. Petersburg and Leningrad Region», St. Petersburg

3 GBUZ «Leningrad Regional Hospital», St. Petersburg

For citation: Mazurok VA, Golovkin AS, Bautin AE, Gorelov II, Belikov VL, Slivin ОА. Gastrointestinal Tract in Critical Illness: the First Who Suffers, and the Last Who Recieves the Attention. Intensive Care Herald. 2016;2:28–37.

Gastrointestinal tract functioning in critical illness is discussed. It is pointed out how specific construction of the intestinal wall microcirculation can put the gastrointestinal tract in highly vulnerable position with regard to early oxygen insufficiency development either in low cardiac output syndrome, or in the septic microcirculation disturbance. Especially stressed that failure of the intestinal microcirculation results to disorder of the intestinal permeability — well-known mechanism of systemic inflammation and multi-organ failure. Existent laboratory assays for evaluation of the gastrointestinal tract functioning are observed, as well as the common and possible prophylactic and treatment modalities for the intestinal permeability disorder in critical illness are analyzed. Especially marked that intestinal oxygenotherapy — insufflation of oxygen to the small intestine — may be a promising way for correction of the intestinal barrier disorder.

Keywords: gastrointestinal tract, intestinal permeability, intestinal barrier, oxygen, intestinal oxygenation

Received: 14.02.2016


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