CLINICAL APPLICATION OF PROBIOTICS IN INTENSIVE CARE UNIT (ICU)

Abstract

The gut microbiome comprises a complex community of bacteria that collectively perform various essential functions in the human body. A balanced gut microbiome enhances the host’s defense against infections through mechanisms such as modulation of the local and systemic immune systems, suppression of enteric pathogens, and support of intestinal epithelial barrier integrity. Conversely, an imbalance in the microbiome, known as dysbiosis, has been shown to negatively impact the host and is associated with a variety of disease conditions. This is particularly relevant in the intensive care unit (ICU) setting, where critically ill patients—such as those with respiratory failure, sepsis, myocardial infarction, cardiovascular procedures, intracerebral hemorrhage, and cerebral infarction—experience ongoing disruptions of their microbiome due to both the underlying disease and iatrogenic effects of clinical interventions. Probiotics are live, non-pathogenic microorganisms, primarily bacteria, yeasts, or fungi, that confer health benefits to the human body, especially the digestive system. Broad-spectrum antibiotic use, acute dietary changes, and disease-induced stress can all disrupt the gut microbiome’s homeostasis in patients. As a result, nearly all ICU patients experience severe disruption of the gut microbiome. Case reports discussed in this article show that probiotics may reduce the incidence of ventilator-associated pneumonia (VAP), the duration of mechanical ventilation, ICU length of stay, and hospital mortality.