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Early Gut Microbiome-Short-Chain Fatty Acid Axis Disruption May Be Associated with Delayed Recovery in Critically Ill
Yoon Kyung Cho1,2, Kyeong Hun Lee1, Hyun Mi Kang1,2
1Department of Pediatrics, Seoul St. Mary's Hospital, Seoul 06591, Republic of Korea.
Nutrients
|May 27, 2026
Summary
Early disruption of the gut microbiome and short-chain fatty acids (SCFAs) in critically ill children may indicate slower recovery. Gut microbial diversity shows promise as a recovery marker beyond standard scores.
Area of Science:
- Microbiology
- Metabolomics
- Pediatric Critical Care
Background:
- The gut microbiome and its metabolites, like short-chain fatty acids (SCFAs), are crucial for immune-metabolic balance.
- The link between early gut microbiome disruption and recovery in pediatric intensive care unit (PICU) patients is not well understood.
- Novel biological markers for recovery in pediatric critical illness are needed.
Purpose of the Study:
- To investigate the association between early gut microbiome disruption, fecal SCFA profiles, and clinical recovery in critically ill children.
- To explore the potential of gut microbial diversity and SCFA concentrations as markers of recovery trajectory.
Main Methods:
- Prospective observational study of 26 PICU patients.
- Fecal samples collected within 5 days of admission.
- Assessed microbial diversity (16S rRNA sequencing, Shannon index) and fecal SCFAs (targeted metabolomics).
- Measured disease severity (Pediatric Index of Mortality 3) and PICU length of stay (LOS).
Main Results:
- Reduced microbial diversity trended with younger age and higher disease severity.
- Early loss of gut microbial diversity correlated with lower fecal butyric acid concentrations.
- Lower microbial diversity was significantly inversely associated with PICU LOS.
- Fecal butyric acid alone was not directly associated with LOS.
Conclusions:
- Early gut microbiome disruption, marked by reduced diversity and butyrate, showed a trend towards delayed recovery in PICU patients.
- Gut microbial ecosystem integrity may serve as a relevant recovery marker beyond conventional severity scores.
- Further research is needed to validate these findings in larger cohorts.
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