The following is the summary of “Central role of the gut in intensive care” published in the December 2022 issue of Critical care by Corriero, et al.

Patients who are critically ill are more likely to experience early damage of their gut microbiota (GM) due to routine antibiotic treatments and other environmental variables that can contribute to intestinal dysbiosis. The GM connects with the rest of the human body along various axes representing essential inter-organ crosstalks. These crosstalks, which play a major role in the pathophysiology of numerous diseases and the consequences that arise from them, can be disturbed when the GM is diseased. 

Metabolites of genetically modified organisms, such as short-chain fatty acids and bile acids, neurotransmitters, hormones, interleukins, and toxins, are important participants in this communication. The gut is connected to the rest of the body in many different ways, and intensivists must work at the intersection of these linkages. Utilizing GM in the intensive care Unit can improve patient care for several challenging conditions, including infections, traumatic brain injuries, heart failure, renal injury, and liver dysfunction. Unfortunately, the investigation of molecular pathways altered by the GM in various clinical illnesses is still in its preliminary stages, and there is a shortage of evidence in patients who are severely ill. 

This review will attempt to describe dysbiosis in critical illness and provide intensivists with a perspective on the potential of adjuvant strategies (such as nutrition, probiotics, prebiotics, synbiotics supplementation, adsorbent charcoal, beta-lactamase, and fecal microbiota transplantation) to modulate the GM in the intensive care unit patients and attempt to restore eubiosis.

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-022-04259-8