Summary of round table conference: gut dysfunction in critical illness.

There is recent evidence that intestinal function is an important determinant in the outcome of critically ill patients. The barrier function is an important characteristic of the gut. Its workings are complex and it consists of epithelial, molecular, and immune components. The pathogenesis of gut dysfunction among critically ill patients is multifactorial, consisting of the quality and quantity of microorganisms, the permeability of the epithelium, and the extent of the vascular perfusion. A practical bedside measure of gut dysfunction is intolerance to enteral feedings. Potential therapies for gut dysfunction include the use of vasoactive drugs to enhance perfusion, selective decontamination to decrease bacteria and endotoxin, and the early and frequent administration of enteral nutrients.