The gut has a major influence on the course of the human stress response in critical illness
for several reasons; the quantity of its immune tissue, the extent of interface with the external
environment, the expanse of the microbiome, and its access to the systemic circulation. In
critical illness, it is not uncommon to lose mucosal barrier function, which exposes the host to
the downside effects of luminal contents and epithelial cell regulation. In that setting, the
microbiome is converted to a pathobiome, upregulation of metabolic and immune responses …