Daniyah Abdullah Alkhawtani
Prince Sultan Military Medical City, Saudi Arabia
Title: Effect of probiotics and prebiotics on gut integrity in critically ill patients
Biography
Biography: Daniyah Abdullah Alkhawtani
Abstract
Gut failure is common in ICU patients, characterized by lack of bowel sounds, regurgitation, vomiting, high gastric residual volumes (>500 mL/day), diarrhea, constipation, abdominal distension or GI bleeding. During critical illness, several factors might affect gut micro-flora that involve changes in stress hormones, gut ischemia, use of antibiotics and immunosuppression, gut microbiota, lack of nutrients and enteral feeding failure. Unfortunately, clinical evaluation of the gut function is difficult therefore gut dysfunction usually goes unrecognized related to poor clinical outcomes and high morbidity and mortality rate. Diet has the strongest effects on gut microbial colonization that could modify the profile of dominant species in human gut and offer different consequences of health. Recent data suggested preserving or re-establishing a healthy gut microbiota during and after critical diseases through targeted interventions such as probiotics, prebiotics, fecal microbial transplants (FMT), and synthetic stool pills. This review developed to evaluate the efficacy of probiotic/prebiotics in critical ill patients. Probiotics offers many benefits to the host including effective in the treatment or prevention of acute gastroenteritis, GI dysfunctions, antibiotic associated diarrhea (AAD), certain pediatric allergic disorders, necrotizing enterocolitis and inflammatory bowel disease (IBD). Based on the available studies, probiotics promise in reducing overall infections, sepsis, AAD and VAP in critical ill patients. Nonetheless, the role of probiotics on patients with CDAD and severe pancreatitis is still inconclusive. Unfortunately, limited studies are available on prebiotics and symbiotic. Briefly, probiotics use in the ICU remains widespread and no definitive recommendation for the routinely probiotics use in critically ill patients. Further studies are required to define the dose, types and safety of pro- and prebiotics in illness.