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Probiotics in the Intensive Care Unit.

Alex R Schuurman1, Robert F J Kullberg1, Willem Joost Wiersinga1,2

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Summary

Probiotics may help restore the gut microbiome in critically ill patients, potentially preventing infections like ventilator-associated pneumonia. Further research is needed to confirm their efficacy and safety in the intensive care unit (ICU).

Keywords:
dysbiosisintensive care unitmicrobiomeprobioticsventilator-associated pneumonia

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Area of Science:

  • Microbiology
  • Immunology
  • Critical Care Medicine

Background:

  • The gut microbiome plays a crucial role in host defense and immune system regulation.
  • Disturbances in the gut microbiome are linked to adverse outcomes, including superinfections and hospital readmissions.
  • The gut microbiome of critically ill patients is significantly altered, presenting a target for therapeutic interventions.

Purpose of the Study:

  • To review the potential role of probiotics in the intensive care unit (ICU).
  • To discuss the gut microbiome in critically ill patients and the concept of probiotic modulation.
  • To summarize evidence from randomized clinical trials on probiotic use, focusing on preventing ventilator-associated pneumonia.

Main Methods:

  • Narrative review of existing literature.
  • Focus on randomized clinical trials.
  • Highlighting studies with conceptual advances and mechanistic insights.

Main Results:

  • Evidence suggests probiotics may positively modulate the gut microbiome in the ICU setting.
  • Specific focus on the prevention of ventilator-associated pneumonia (VAP) is examined.
  • Challenges, efficacy, and safety of probiotics in critically ill patients are considered.

Conclusions:

  • Probiotic interventions show promise for managing the gut microbiome in the ICU.
  • Further investigation is required to establish optimal use, efficacy, and safety profiles.
  • Future research should address current challenges and explore potential benefits in critically ill populations.