Abstract:
The gut microbiota plays a crucial role in the human microenvironment. Dysbiosis of the gut microbiota is a common pathophysiological phenomenon in critically ill patients. Therefore, utilizing intestinal microbiota to prevent complications and improve the prognosis of critically ill patients is a possible therapeutic direction. The gut microbiome-based therapeutics approach focuses on improving intestinal microbiota homeostasis by modulating its diversity, or treating critical illness by altering the metabolites of intestinal microbiota. There is growing evidence that fecal microbiota transplantation (FMT), selective digestive decontamination (SDD), and microbiota-derived therapies are all effective treatments for critical illness. However, different treatments are appropriate for different conditions, and more evidence is needed to support the selection of optimal gut microbiota-related treatments for different diseases. This narrative review summarizes the curative effects and limitations of microbiome-based therapeutics in different critically ill adult patients, aiming to provide possible directions for gut microbiome-based therapeutics for critically ill patients such as ventilator-associated pneumonia, sepsis, acute respiratory distress syndrome, and COVID-19, etc.
摘要:
肠道菌群在人类微环境中起着至关重要的作用。肠道菌群失调是危重病人常见的病理生理现象。因此,利用肠道菌群预防并发症和改善危重患者预后是可能的治疗方向。基于肠道微生物组的治疗方法侧重于通过调节其多样性来改善肠道微生物群的稳态,或通过改变肠道微生物群的代谢物来治疗危重病。越来越多的证据表明,粪便微生物移植(FMT),选择性消化净化(SDD),和微生物来源的疗法都是治疗危重病的有效方法。然而,不同的治疗方法适合不同的情况,需要更多的证据来支持针对不同疾病选择最佳的肠道微生物群相关治疗方法。这篇叙述性综述总结了基于微生物组的疗法在不同危重成人患者中的疗效和局限性。旨在为呼吸机相关性肺炎等危重病人提供基于肠道微生物组的治疗方法的可能方向,脓毒症,急性呼吸窘迫综合征,和COVID-19等。