CIRCULATORY INSTABILITYPRIMARY INFECTIOUS AGENTS Hypoxic-ischemic eventBacteria, Bacterial toxin, Virus, PolycythemiaFungus MUCOSAL INJURYINFLAMMATORY MEDIATORSInflammatory cells ENTERAL FEEDINGS(macrophage) Platelet activating Hypertonic formula orfactor (PAF) Tumor necrosis medication Malabsorption,factor (TNF) Leukotriene C4, gaseous distention H2 gasInterleukin 1; 6 production, Endotoxin