Table 1 Immunonutrition in critically ill patients: clinical settings, outcomes, and research gaps
From: Therapeutic Potential of the Gut Microbiota in the Management of Sepsis
Clinical settings | Products | Outcomes | Research gaps |
|---|---|---|---|
Mechanically ventilated patients | Probiotics Synbiotics | Incidence of VAP | Choice of probiotics/synbiotics; dosing and route of administration VAP definition Adverse effects evaluation Paucity of data on the effect on MDR colonization |
Elective surgery/ trauma | Probiotics Synbiotics | Incidence of postoperative/post-traumatic infections | Paucity of data on microbiota before surgery Choice of probiotics/synbiotics; dosing and route of administration Adverse effects evaluation |
Pre-term infants | Probiotics Synbiotics | Incidence of sepsis Incidence of necrotizing enterocolitis | Impact of type of feeding (mother’s milk, donor milk, formula) Evaluation of impact of human milk oligosaccharides on microbiome Choice of single probiotic strain versus multiple strains To address the risk of probiotic-related sepsis and transmission of antibiotic resistance To address the risk of cross-colonization or cross-contamination |
ICU patients | Probiotics Synbiotics | Incidence of new infections Mortality ICU length stay | Choice of probiotics/synbiotics; dosing and route of administration To address short- and long-term effects on gut microbiome To address candidate populations and timing of administration |