The simultaneous dysfunction of several organs represents a challenging task for the intensivist. Systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) are expressions of an inappropriate generalized inflammatory response of the host to a variety of infectious or non-infectious stimuli. In recent years, MODS is being encountered frequently in critically ill patients due to several causes. Experimental and clinical evidence suggests that the gut, endothelium and immune system interact to produce altered metabolic and cardiorespiratory patterns. It is thus possible that a target-oriented approach, including correction of intestinal hypoperfusion, supply of specific nutrients and downregulation of the inflammatory cascade, can act as either a preventive measure for subjects as risk or as the treatment for patients with full-blown MODS.