Wozniak Hannah, Balzani Eleonora, Lazarevic Vladimir, Gaia Nadia, de Watteville Aude, Giraud Raphaël, Schrenzel Jacques, Heidegger Claudia
Intensive Care Unit, Department of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland.
Centre for Medical Sciences-CISMed, University of Trento, Via S. Maria Maddalena 1, 38122, Trento, Italy.
Intensive Care Med Exp. 2025 Aug 28;13(1):88. doi: 10.1186/s40635-025-00803-2.
Critical illness is known to reduce gut microbiota (GM) diversity, a change associated with adverse outcomes. Among potential mechanisms, splanchnic hypoperfusion may play a key role. Cardiac arrest (CA), characterized by transient global hypoperfusion, provides a relevant model to explore this effect.
We conducted a secondary, propensity score-matched analysis of a cohort study investigating GM changes during early intensive care unit stay. Stool samples were collected at ICU admission (S1) and at least 24 h later (S2). GM profiling was performed using 16S rRNA sequencing. Shannon diversity index and taxonomic composition were compared between CA and non-CA patients. Propensity score matching and generalized linear models (GLM) were used to adjust for confounding. A total of 26 patients were included in this analysis (13 CA, 13 matched controls). At S1, CA patients had significantly lower GM diversity (Shannon index: 3.6 [3.0-3.8] vs. 4.3 [3.9-4.8], p = 0.019). This was confirmed in the GLM (β = - 0.30, SE 0.12, p = 0.022). At S2, diversity remained lower (3.2 [2.7-3.8] vs. 4.0 [3.7-4.3], p = 0.064). While no global compositional shifts were observed between groups, differences in the abundance of specific taxa were noted.
CA is associated with reduced GM diversity in the first few days of intensive care unit admission compared to non-CA patients, supporting a role for splanchnic hypoperfusion in GM modulation. Further research should investigate clinical consequences and evaluate microbiota-targeted interventions in this high-risk population.
已知危重病会降低肠道微生物群（GM）多样性，这种变化与不良预后相关。在潜在机制中，内脏低灌注可能起关键作用。心脏骤停（CA）以短暂的全身性低灌注为特征，为探索这种效应提供了一个相关模型。
我们对一项队列研究进行了二次倾向评分匹配分析，该研究调查了重症监护病房早期住院期间的GM变化。在重症监护病房入院时（S1）和至少24小时后（S2）采集粪便样本。使用16S rRNA测序进行GM分析。比较了CA患者和非CA患者的香农多样性指数和分类组成。采用倾向评分匹配和广义线性模型（GLM）来调整混杂因素。本分析共纳入26例患者（13例CA患者，13例匹配对照）。在S1时，CA患者的GM多样性显著降低（香农指数：3.6 [3.0 - 3.8] 对 4.3 [3.9 - 4.8]，p = 0.019）。这在GLM中得到证实（β = - 0.30，标准误0.12，p = 0.022）。在S2时，多样性仍然较低（3.2 [2.7 - 3.8] 对 4.0 [3.7 - 4.3]，p = 0.064）。虽然两组之间未观察到整体组成变化，但注意到特定分类群丰度存在差异。
与非CA患者相比，CA患者在重症监护病房入院后的头几天GM多样性降低，支持内脏低灌注在GM调节中的作用。进一步的研究应调查临床后果，并评估针对这一高危人群的微生物群靶向干预措施。
