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The Importance of the Microbiome in Critically Ill Patients: Role of Nutrition

Critically ill patients have an alteration in the microbiome in which it becomes a disease-promoting pathobiome. It is characterized by lower bacterial diversity, loss of commensal phyla, like Firmicutes and Bacteroidetes, and a domination of pathogens belonging to the Proteobacteria phylum. Althoug...

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Autores principales: Moron, Rocio, Galvez, Julio, Colmenero, Manuel, Anderson, Per, Cabeza, José, Rodriguez-Cabezas, Maria Elena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6950228/
https://www.ncbi.nlm.nih.gov/pubmed/31817895
http://dx.doi.org/10.3390/nu11123002
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author Moron, Rocio
Galvez, Julio
Colmenero, Manuel
Anderson, Per
Cabeza, José
Rodriguez-Cabezas, Maria Elena
author_facet Moron, Rocio
Galvez, Julio
Colmenero, Manuel
Anderson, Per
Cabeza, José
Rodriguez-Cabezas, Maria Elena
author_sort Moron, Rocio
collection PubMed
description Critically ill patients have an alteration in the microbiome in which it becomes a disease-promoting pathobiome. It is characterized by lower bacterial diversity, loss of commensal phyla, like Firmicutes and Bacteroidetes, and a domination of pathogens belonging to the Proteobacteria phylum. Although these alterations are multicausal, many of the treatments administered to these patients, like antibiotics, play a significant role. Critically ill patients also have a hyperpermeable gut barrier and dysregulation of the inflammatory response that favor the development of the pathobiome, translocation of pathogens, and facilitate the emergence of sepsis. In order to restore the homeostasis of the microbiome, several nutritional strategies have been evaluated with the aim to improve the management of critically ill patients. Importantly, enteral nutrition has proven to be more efficient in promoting the homeostasis of the gut microbiome compared to parenteral nutrition. Several nutritional therapies, including prebiotics, probiotics, synbiotics, and fecal microbiota transplantation, are currently being used, showing variable results, possibly due to the unevenness of clinical trial conditions and the fact that the beneficial effects of probiotics are specific to particular species or even strains. Thus, it is of great importance to better understand the mechanisms by which nutrition and supplement therapies can heal the microbiome in critically ill patients in order to finally implement them in clinical practice with optimal safety and efficacy.
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spelling pubmed-69502282020-01-16 The Importance of the Microbiome in Critically Ill Patients: Role of Nutrition Moron, Rocio Galvez, Julio Colmenero, Manuel Anderson, Per Cabeza, José Rodriguez-Cabezas, Maria Elena Nutrients Review Critically ill patients have an alteration in the microbiome in which it becomes a disease-promoting pathobiome. It is characterized by lower bacterial diversity, loss of commensal phyla, like Firmicutes and Bacteroidetes, and a domination of pathogens belonging to the Proteobacteria phylum. Although these alterations are multicausal, many of the treatments administered to these patients, like antibiotics, play a significant role. Critically ill patients also have a hyperpermeable gut barrier and dysregulation of the inflammatory response that favor the development of the pathobiome, translocation of pathogens, and facilitate the emergence of sepsis. In order to restore the homeostasis of the microbiome, several nutritional strategies have been evaluated with the aim to improve the management of critically ill patients. Importantly, enteral nutrition has proven to be more efficient in promoting the homeostasis of the gut microbiome compared to parenteral nutrition. Several nutritional therapies, including prebiotics, probiotics, synbiotics, and fecal microbiota transplantation, are currently being used, showing variable results, possibly due to the unevenness of clinical trial conditions and the fact that the beneficial effects of probiotics are specific to particular species or even strains. Thus, it is of great importance to better understand the mechanisms by which nutrition and supplement therapies can heal the microbiome in critically ill patients in order to finally implement them in clinical practice with optimal safety and efficacy. MDPI 2019-12-07 /pmc/articles/PMC6950228/ /pubmed/31817895 http://dx.doi.org/10.3390/nu11123002 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Moron, Rocio
Galvez, Julio
Colmenero, Manuel
Anderson, Per
Cabeza, José
Rodriguez-Cabezas, Maria Elena
The Importance of the Microbiome in Critically Ill Patients: Role of Nutrition
title The Importance of the Microbiome in Critically Ill Patients: Role of Nutrition
title_full The Importance of the Microbiome in Critically Ill Patients: Role of Nutrition
title_fullStr The Importance of the Microbiome in Critically Ill Patients: Role of Nutrition
title_full_unstemmed The Importance of the Microbiome in Critically Ill Patients: Role of Nutrition
title_short The Importance of the Microbiome in Critically Ill Patients: Role of Nutrition
title_sort importance of the microbiome in critically ill patients: role of nutrition
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6950228/
https://www.ncbi.nlm.nih.gov/pubmed/31817895
http://dx.doi.org/10.3390/nu11123002
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