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Probiotics may alleviate intestinal damage induced by cardiopulmonary bypass in children

Daisuke Toritsuka1, Masaya Aoki1, Akihiko Higashida2

  • 1Department of Cardiovascular Surgery, Graduate School of Medicine, University of Toyama, Toyama, Japan.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|April 10, 2024
PubMed

Insights

Probiotics corrected gut dysbiosis after cardiopulmonary bypass but did not prevent intestinal damage. Further research is needed for effective interventions against cardiac surgery-induced gut disturbances.

Area of Science:

  • Gastroenterology
  • Cardiology
  • Microbiology

Background:

  • Cardiopulmonary bypass (CPB) can induce intestinal ischemia-reperfusion injury, leading to barrier dysfunction, dysbiosis, and bacterial translocation.
  • Understanding these effects is crucial for managing patients undergoing cardiac surgery.

Purpose of the Study:

  • To investigate epithelial barrier dysfunction and bacterial translocation following CPB.
  • To assess the impact of probiotics on CPB-induced gut microbiota changes and related conditions.

Main Methods:

  • A randomized prospective study involving 82 pediatric patients (0-15 years) undergoing cardiac surgery with CPB.
  • Patients were allocated to receive probiotics (intervention) or no probiotics (control).
  • Analysis included fecal and blood microbiota, organic acids, intestinal fatty acid-binding protein, and immunological responses.

Main Results:

  • Probiotics increased obligate anaerobes and corrected dysbiosis post-CPB (after day 7).
  • No significant differences were observed between groups in bacterial translocation, intestinal damage markers (intestinal fatty acid-binding protein), or most immunological responses.
  • Probiotics did not sufficiently alleviate intestinal damage induced by CPB.

Conclusions:

  • Probiotics can modulate the gut microbiota towards a less dysbiotic state after CPB.
  • Current probiotic administration is insufficient to prevent or mitigate CPB-induced intestinal damage.
  • Novel strategies are required to prevent gut disturbances associated with cardiac surgery and CPB.
Abstract

Keywords:
Bacterial translocationCardiopulmonary bypassCongenital heart diseaseGut microbiotaIntestinal barrier functionProbiotics

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