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Minerva Anestesiologica 2020 July;86(7):777-85

DOI: 10.23736/S0375-9393.20.14278-0

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Microbiome: what intensivists should know

Radislav NAKOV ¹, Jonathan P. SEGAL ², Carlo R. SETTANNI ³, Stefano BIBBÒ ³, Antonio GASBARRINI ³, Giovanni CAMMAROTA ³, Gianluca IANIRO ³ ✉

¹ Department of Gastroenterology, Tsaritsa Yoanna University Hospital, Medical University of Sofia, Sofia, Bulgaria; ² Department of Gastroenterology, St Mark’s Hospital, Harrow, UK; ³ Digestive Disease Center, IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy

The standard conditions of critical illness (including sepsis, acute respiratory distress syndrome, and multiorgan failure) cause enormous global mortality and a growing economic burden. Increasing evidence suggests that critical illness may be associated with loss of commensal microbes and overgrowth of potentially pathogenic and inflammatory bacteria. This state could be associated with poor outcomes. Therefore, microbiota-targeted interventions are potentially attractive novel treatment options. Although the precise mechanisms of microbiome-directed treatments such as prebiotics, probiotics, and fecal microbiota transplantation remain to be determined, they can be utilized in the Intensive Care Unit (ICU) setting. The current review aims to offer intensivists an evidenced-based approach on what we currently know about the role of the microbiome in critical illness and how the microbiome could be targeted in the clinical practice to improve ICU-related outcomes.

KEY WORDS: Microbiota; Intensive Care Units; Gastrointestinal microbiome