The microbiome and nutrition in critical illness

• Type of Material: Article
• Authors: Takehiko Oami, Emory University; Deena B. Chihade, Emory University; Craig Coopersmith, Emory University
• Language: English
• Date: 2019-04-01
• Publisher: Lippincott Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019 Wolters Kluwer Health, Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1097/MCC.0000000000000582
• Title of Journal or Parent Work: Current Opinion in Critical Care
• Volume: 25
• Issue: 2
• Start Page: 145
• End Page: 149
• Grant/Funding Information: Disclosure of Funding: This work was supported by the National Institutes of Health; This work was supported by the National Institutes of Health (GM072808, GM095442, GM104323, GM109779, GM113228).
• Keywords: Critical Care Medicine; Care medicine SCCM; Bacterial; General & Internal Medicine; nutrition; pathobiome; Bifidobacteria; Science & Technology; American society; Intestinal microbiota; probiotics; Gut microbiota; Ill patient society; Enternal nutrition; ICU; Fecal microbiota; Life Sciences & Biomedicine; microbiome; Support therapy
• Research Categories: Biology, Microbiology; Health Sciences, Public Health; Health Sciences, Health Care Management; Health Sciences, Nutrition

Abstract

Purpose of review: The present review aims to describe the relationship between nutrition and the gut microbiome in critical illness. Recent findings: Critical illness disrupts not only cells of human origin but also the intestinal microbiome, with a decrease in bacterial diversity and transformation into a pathobiome. Under basal conditions, nutrition profoundly alters microbial composition with significant salutatory effects on human health. In critical illness, enteral nutrition is recommended and has theoretical (but not proven) advantages towards improved inner microbial health and diminution of bacterial translocation. Dietary supplements such as probiotics and fiber have been shown to improve microbial derangements in health. However, their impact on the microbiome in critical illness is unclear and although they may have some beneficial effects on patient-centric outcomes, they do not alter mortality. The precise mechanisms of how nutrition and dietary supplements modulate the gut microbiome remain to be determined. Summary: Nutrition and supplements such as probiotics appear to play a significant role in modulating the microbiome in health, yet the relationship in critical illness is unclear. Further investigation is required to determine the mechanistic determinants of the impact of nutrition on the microbiome in critical illness and the potential clinical implications of this.