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The Gut in Critical Illness.

Jayshil J Patel1, Mark Barash2

  • 1Division of Pulmonary, Critical Care, and Sleep Medicine, Medical College of Wisconsin, 8701 West Watertown Plank Road, 8th Floor: HUB for Collaborative Medicine, Milwaukee, WI, 53226, USA. jpatel2@mcw.edu.

Current Gastroenterology Reports
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PubMed
Summary
This summary is machine-generated.

Critical illness disrupts the gut barrier and microbiome, potentially driving systemic inflammation and organ failure. Therapies aim to preserve gut function and beneficial bacteria during critical illness.

Keywords:
Critical illnessEnteral nutritionGut barrier functionInflammationMicrobiomeParenteral nutrition

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Area of Science:

  • Gastroenterology
  • Critical Care Medicine
  • Microbiology

Background:

  • Critical illness profoundly impacts gastrointestinal function.
  • Pathophysiology and interventions compromise gut barrier integrity.
  • The gut microbiome shifts from a symbiotic state to a pathobiome.

Purpose of the Study:

  • To elucidate mechanisms of gut dysfunction in critical illness.
  • To explore hypotheses of gut-derived inflammation.
  • To identify therapies that preserve gut barrier function and microbiota.

Main Methods:

  • Narrative review of clinical and animal model studies.
  • Analysis of existing literature on gut dysfunction and critical illness.
  • Synthesis of findings on therapeutic interventions.

Main Results:

  • Critical illness and its treatments damage the gut epithelium and alter the microbiome.
  • The gut is implicated as a central driver of systemic inflammation and multi-organ failure.
  • Gut barrier function and microbiome status correlate with critical illness outcomes.

Conclusions:

  • Maintaining gut barrier integrity is crucial for managing critical illness.
  • Therapeutic strategies should focus on preserving a healthy gut microbiome.
  • Gut health is a key determinant in the trajectory of critical illness and immune regulation.