The microbiome and nutrition in critical illness

Oami, Takehiko; Chihade, Deena B.; Coopersmith, Craig M.

doi:10.1097/mcc.0000000000000582

Cited by 35 publications

(27 citation statements)

References 51 publications

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“…Further, antibiotic treatments invite an increase in fungal colonization and can exaggerate the allergic response. For example, changes in gut microbiota in critically ill patients include depletion of butyrate-producing microbes and a subsequent overgrowth of virulent strains of Escherichia/Shigella, Salmonella, Enterococcus, Clostridium difficile or Staphylococcus [53] .…”

Section: Microbiome Involvement In Vap Prevention and Treatmentmentioning

confidence: 99%

Reconsidering ventilator-associated pneumonia from a new dimension of the lung microbiome

2020

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Complex microbial communities that reside in the lungs, skin and gut are now appreciated for their role in maintaining organ, tissue and immune homoeostasis. As lungs are currently seen as an ecosystem, the shift in paradigm calls for the consideration of new algorithms related to lung ecology in pulmonology. Evidence of lung microbiota does not solely challenge the traditional physiopathology of ventilator-associated pneumonia (VAP); indeed, it also reinforces the need to include molecular techniques in VAP diagnosis and accelerate the use of immunomodulatory drugs, including corticosteroids, and other supplements such as probiotics for VAP prevention and/or treatment. With that stated, both microbiome and virome, including phageome, can lead to new opportunities in further understanding the relationship between health and dysbiosis in VAP. Previous knowledge may be, however, reconsidered at a microbiome scale.

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Section: Microbiome Involvement In Vap Prevention and Treatmentmentioning

confidence: 99%

Reconsidering ventilator-associated pneumonia from a new dimension of the lung microbiome

2020

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“…However, exact mechanisms remain hypothetical. Factors leading to the development of pathobiome in critical illness have been reviewed recently 68 …”

Section: Introductionmentioning

confidence: 99%

Enteral Feeding Intolerance: Updates in Definitions and Pathophysiology

et al. 2020

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Enteral feeding intolerance (EFI) is a common feature in critically ill patients worldwide. However, there is no clear, widely agreed‐upon definition available, with various studies rarely using the same definition. The term EFI is frequently used to describe vomiting or large gastric residual volumes associated with enteral feeding as a result of gastroparesis/delayed gastric emptying. However, the syndrome of EFI may represent the consequence of various pathophysiological mechanisms, and this heterogeneity may explain varying associations with outcomes. In clinical practice, a pragmatic definition may be useful. A pragmatic definition of EFI is that a clinician has decided to reduce the amount of enteral nutrition specifically because features of gastrointestinal dysfunction appeared during enteral feeding. For research purposes, a more detailed definition of EFI is required to improve knowledge and explore interventions that may improve patient‐centered outcomes. The objective of this review is to summarize available evidence on existing definitions, pathophysiological mechanisms, and the clinical relevance of EFI in critically ill patients. Based on current knowledge, we propose a conceptual framework for a definition of EFI for a future consensus process.

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“…In agreement, gut and airway microbial diversities were inversely correlated with the severity of illness and mortality [97]. More studies are needed, however, to explore how microbial diversity is affected by timing, dose, and route of nutrition support, and how these changes impact upon patient outcomes [98].…”

Section: Microbiomementioning

confidence: 81%

“…Gut microbiome diversity, as assessed by 16S microbial sequencing or metagenomics, is another candidate multidimensional biomarker that is significantly altered during critical illness [ 95 – 97 ], can be modified by nutrient intake [ 98 ], and leads to adaptive or pathophysiological mechanisms that may alter clinical outcomes [ 31 ]. In agreement, gut and airway microbial diversities were inversely correlated with the severity of illness and mortality [ 97 ].…”

Section: Developing Effective Biomarkers Of Nutritionmentioning

confidence: 99%

Biomarkers in critical care nutrition

Stoppe

Wendt²,

Mehta

et al. 2020

Crit Care

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The goal of nutrition support is to provide the substrates required to match the bioenergetic needs of the patient and promote the net synthesis of macromolecules required for the preservation of lean mass, organ function, and immunity. Contemporary observational studies have exposed the pervasive undernutrition of critically ill patients and its association with adverse clinical outcomes. The intuitive hypothesis is that optimization of nutrition delivery should improve ICU clinical outcomes. It is therefore surprising that multiple large randomized controlled trials have failed to demonstrate the clinical benefit of restoring or maximizing nutrient intake. This may be in part due to the absence of biological markers that identify patients who are most likely to benefit from nutrition interventions and that monitor the effects of nutrition support. Here, we discuss the need for practical risk stratification tools in critical care nutrition, a proposed rationale for targeted biomarker development, and potential approaches that can be adopted for biomarker identification and validation in the field.

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The microbiome and nutrition in critical illness

Cited by 35 publications

References 51 publications

Reconsidering ventilator-associated pneumonia from a new dimension of the lung microbiome

Reconsidering ventilator-associated pneumonia from a new dimension of the lung microbiome

Enteral Feeding Intolerance: Updates in Definitions and Pathophysiology

Biomarkers in critical care nutrition

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