Considering that intestinal microbiota plays a crucial role in intestinal function, fecal microbiota transplantation (FMT) may provide a new therapeutic strategy for the treatment of intestinal nutrition intolerance in critically ill ICU patients. The purpose of this study was to investigate the effects of FMT on the recovery of gastrointestinal dysfunction-induced enteral nutrition intolerance in critically ill patients admitted to ICU, and observe the effects on gastrointestinal barrier function, as well as the effects on length of stay in ICU, ICU mortality, in-hospital mortality, and 28-day mortality.
Patients in the intensive care unit (ICU) are often at risk for gastrointestinal dysfunction and malnutrition. Gastrointestinal dysfunction is associated with poorer clinical outcomes, including longer mechanical ventilation, longer ICU stay, and increased 90-day mortality. Due to the influence of primary severe diseases and the use of proton pump inhibitors (PPI) and antibiotics, ICU patients with severe illness may have severe disturbance of intestinal flora, impairment of intestinal barrier function, high incidence of gastrointestinal dysfunction-induced enteral nutrition intolerance, and severe intestinal systemic inflammation and organ function injury. Considering that intestinal microbiota plays a crucial role in intestinal function, fecal microbiota transplantation (FMT) may provide a new therapeutic strategy for the treatment of gastrointestinal dysfunction-induced enteral nutrition intolerance in critically ill ICU patients. The project plans through nasal jejunal tube way to give FMT, to investigate its effect on the recovery of gastrointestinal dysfunction-induced enteral nutrition intolerance in severe patients admitted to ICU, and to observe its effect on gastrointestinal barrier function.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
19
FMT was administered via a naso-jejunal tube to inject 50ml commercial intestinal bacterial suspension into the jejunum.
Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
Wuhan, Hubei, China
Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
Wuhan, China
Percentage of the effective improvement of enteral nutrition intolerance
Change of intestinal nutrition intolerance.
Time frame: 24, 48, 72 and 96 hours after first FMT.
Changes of intestinal microbiota and its metabolites
Rectal swab was taken and analysed by 16S rRNA gene sequencing and metabolomics.
Time frame: -48, 72 and 96 hours after first FMT.
Intestinal barrier function
2ml of peripheral venous blood was collected for the measurement of serum lipopolysaccharide (LPS), diamine oxidase (DAO), and D-lactic acid.
Time frame: -24, 0, 24, 48, 72 and 96 hours after first FMT.
Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ score
Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ score is a scoring system used to assess the severity of critically ill patients. APACHE II score ranges from 0 to 71. The higher the score, the greater the severity and the poorer the prognosis.
Time frame: -48, -24, 0, 24, 48, 72 and 96 hours after first FMT.
C-reactive protein (CRP)
2ml of peripheral venous blood was collected for the measurement of CRP.
Time frame: -48, -24, 0, 24, 48, 72 and 96 hours after first FMT.
Peripheral blood cytokines and lymphocyte subsets
2ml of peripheral venous blood was collected for the measurement of the levels of cytokines and the absolute number of lymphocyte subsets.
Time frame: -24 and 72 hours after inclusion.
28-day mortality
Mortality rate of patients in each group within 28 days after inclusion.
Time frame: 28 days after inclusion.
90-day mortality
Mortality rate of patients in each group within 90 days after inclusion.
Time frame: 90 days after inclusion.
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