The gastrointestinal tract in critical illness: Nutritional implications

Hank Schmidt, Robert Martindale

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations


Purpose of review: Recognition that the gastrointestinal tract is a key element of the immune system has led to a greater interest in understanding its role as a central figure in host defenses. Biologic systems that are perturbed by any destabilizing stimulus are known to respond by adaptive strategies in an attempt to maintain or return to global homeostasis. In critically ill patients, the gut has previously been described as a promoter of progression to sepsis and multi-organ failure. However, with better understanding of gastrointestinal tract mucosal immunity, we are now provided with a new arsenal to combat nosocomial infection and significantly impact return to health. Recent findings: In this review we focus on five key topics in the rapidly expanding landscape of knowledge on the gastrointestinal tract in the critical care setting. These include a discussion of probiotic therapy, now the new frontier of immuno-nutrition, the concept of ischemia/reperfusion injury and changes in gut permeability, anti-oxidant and micronutrient therapy, blood glucose regulation, and enhancement of gut motility, all in the intensive care setting. Summary: Ongoing research in nutritional support in both normal and pathologic gastrointestinal function and response to injury has opened the door to several new opportunities for enhancing rapid recovery in critical care.

Original languageEnglish (US)
Pages (from-to)587-591
Number of pages5
JournalCurrent Opinion in Clinical Nutrition and Metabolic Care
Issue number5
StatePublished - Sep 1 2003
Externally publishedYes


  • Critical care
  • Critical illness
  • Gastrointestinal tract
  • Mucosal immunity
  • Nutrition

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


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