Dysfunction of the gastrointestinal tract in critically ill patients has recently become a focus of intensive research. This book is a comprehensive overview on what is currently known of the role of the gut in patients requiring intensive care. The normal barrier, absorptive and immune functions of the gut are reviewed in order to better define the basis of what can be regarded as gut dysfunction. The definitions and pathogenesis of intestinal dysfunction are critically evaluated. Currently available and potential new ways to monitor intestinal function in the intensive care setting are presented. Emphasis has been placed on evaluation of therapeutic strategies in the prevention and treatment of gut dysfunction. Possibilities of monitoring and treating gut dysfunction in critically ill patients are rapidly evolving. This is the first book to be published on this topic. It provides state-of-the-art information for both clinicians and clinical researchers involved in the care of the critically ill.

Inhalt

Gastrointestinal Structure and Function.- Pathophysiology of Gut Dysfunction in Shock and Sepsis.- Intestinal Musosal Hyperpermeability in Critical Illness.- Molecular Mechanisms of Intestinal Injury, Repair, and Growth.- Regulation of Gut Perfusion.- Regulation of Gut Oxygen Delivery, Cellular Oxygen Supply and Metabolic Activity.- Immunology of the Gut.- Mast Cells and Neutrophils in Intestinal Ischemia/Reperfusion.- Clinical Markers of Gastrointestinal Dysfunction.- Bacterial Translocation.- Bacterial Translocation: Intestinal Epithelial Permeability.- Is Bacterial Translocation Clinically Relevant?.- Experimental Multiple Organ Failure and Gut Dysfunction.- Intestinal Cytokines.- Selective Decontamination of the Digestive Tract.- Increased Gastrointestinal Permeability.- Gut Dysfunction in Trauma Patients.- Gut Perfusion.- Gastrointestinal Mucosal Ischemia.- Monitoring Gut Perfusion.- Effects of Pharmacologic Agents on Splanchnic Blood Flow.- Therapeutic Options to Increase Splanchnic Blood Flow.- Gut Metabolism.- Gastrointestinal Exocrine Failure in Critical Illness.- Early Enteral Nutrition in the Surgical Patient.- Glutamine: A Gut Essential Amino Acid.- Enteral Nutrition Support in Surgical Intensive Care Patients.- Enteral Diets in Critically Ill Patients.- Future Directions.- Experimental Advances in Intestinal Monitoring.- Growth Factors and the Intestine.