Shimizu Kentaro, Ogura Hiroshi, Oda Jun
Department of Traumatology and Acute Critical Medicine Osaka University Graduate School of Medicine Suita Osaka Japan.
Acute Med Surg. 2025 Jun 3;12(1):e70068. doi: 10.1002/ams2.70068. eCollection 2025 Jan-Dec.
The gut is a target organ that functions as the "motor" of critical illness. In patients with critical illness, the disrupted gut microbiota following infection and injury could cause diarrhea, pneumonia, and systemic inflammation. For maintaining the gut microbiota, therapeutic approaches are required to modulate host responses and prevent systemic inflammation. Probiotics and synbiotics could maintain the gut microbiota and decrease not only the incidence of diarrhea but also that of ventilator-associated pneumonia. The effects of probiotics/synbiotics differ with the type of bacteria and disease severity. Adverse effects of probiotics have been reported; therefore, the selection of safe and effective probiotics/synbiotics is warranted. Refractory diarrhea with prolonged dysbiosis may require a novel intestinal therapy, such as fecal microbiota transplantation, to alleviate gut dysbiosis.
肠道是一个靶器官，起着危重病“发动机”的作用。在危重病患者中，感染和损伤后肠道微生物群紊乱可导致腹泻、肺炎和全身炎症。为维持肠道微生物群，需要采取治疗方法来调节宿主反应并预防全身炎症。益生菌和合生元可维持肠道微生物群，不仅能降低腹泻的发生率，还能降低呼吸机相关性肺炎的发生率。益生菌/合生元的效果因细菌类型和疾病严重程度而异。已有关于益生菌不良反应的报道；因此，有必要选择安全有效的益生菌/合生元。伴有长期生态失调的难治性腹泻可能需要一种新型肠道疗法，如粪便微生物群移植，以缓解肠道生态失调。
