The central role of the gut in intensive care

Critical Care

Review

Francesco Inchingolo¹  Alberto Corriero²  Nicola Brienza²  Filomena Puntillo²  Antonio Moschetta³  Raffaella Maria Gadaleta³ 

[1] Dental Medicine Section, Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124, Bari, Italy;Department of Interdisciplinary Medicine - ICU Section, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124, Bari, Italy;Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124, Bari, Italy;

关键词: Microbiota;    Microbiome;    Intensive care;    Dysbiosis;    Probiotics;    Prebiotics;    Synbiotics;    Fecal microbiota transplantation;    Critical illness;    Multidrug-resistant bacteria;   

DOI  :  10.1186/s13054-022-04259-8

 received in 2022-09-26, accepted in 2022-11-29,  发布年份 2022

来源: Springer

【 摘 要 】

Critically ill patients undergo early impairment of their gut microbiota (GM) due to routine antibiotic therapies and other environmental factors leading to intestinal dysbiosis. The GM establishes connections with the rest of the human body along several axes representing critical inter-organ crosstalks that, once disrupted, play a major role in the pathophysiology of numerous diseases and their complications. Key players in this communication are GM metabolites such as short-chain fatty acids and bile acids, neurotransmitters, hormones, interleukins, and toxins. Intensivists juggle at the crossroad of multiple connections between the intestine and the rest of the body. Harnessing the GM in ICU could improve the management of several challenges, such as infections, traumatic brain injury, heart failure, kidney injury, and liver dysfunction. The study of molecular pathways affected by the GM in different clinical conditions is still at an early stage, and evidence in critically ill patients is lacking. This review aims to describe dysbiosis in critical illness and provide intensivists with a perspective on the potential as adjuvant strategies (e.g., nutrition, probiotics, prebiotics and synbiotics supplementation, adsorbent charcoal, beta-lactamase, and fecal microbiota transplantation) to modulate the GM in ICU patients and attempt to restore eubiosis.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

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