[The intestines, their role in the critical patient and the concept of bacterial translocation].

The gut is a central organ during critical illnesses that occur as a result of injuries or postoperative infections. After the successful treatment of shock, pulmonary and renal failure, a prolonged septic state emerges, frequently without apparent origin. An immunological host defense failure, associated with the intensive care support that fails to provide the essential amino acid glutamine to the gut, promotes a iatrogenic host invasion by microorganism or soilage by their toxins. This process is called "Bacterial Translocation". The increased permeability of the intestine, coupled with changes in intestinal flora, allows the bowel to serve as a reservoir of pathogens that can enter the portal and systemic circulations and fuel the ongoing septic process. Activating the hepatic reticuloendothelial system, bacterial translocation initiates the Multiple Organ Failure Syndrome. We discuss new therapeutic approaches derived from the aforementioned concepts.