Rapid and Sustained Long-Term Decrease of Fecal Short-Chain Fatty Acids in Critically Ill Patients With Systemic Inflammatory Response Syndrome.

@article{Yamada2015RapidAS,
  title={Rapid and Sustained Long-Term Decrease of Fecal Short-Chain Fatty Acids in Critically Ill Patients With Systemic Inflammatory Response Syndrome.},
  author={Tomoki Yamada and Kentarou Shimizu and Hiroshi Ogura and Takashi Asahara and Koji Nomoto and Kazuma Yamakawa and Toshimitsu Hamasaki and Yasutaka Nakahori and Mitsuo Ohnishi and Yasuyuki Kuwagata and Takeshi Shimazu},
  journal={JPEN. Journal of parenteral and enteral nutrition},
  year={2015},
  volume={39 5},
  pages={
          569-77
        }
}
BACKGROUND The gut is an important target organ for injury after severe insult. Short-chain fatty acids (SCFAs) are end-products of fermentation of dietary fibers by anaerobic microbiota. They are related to intestinal energy, motility, and transport and to protective effects against infection and inflammation. However, there are few clinical data on SCFAs in critically ill patients. We evaluated serial change in fecal SCFAs in patients with severe systemic inflammatory response syndrome (SIRS… 
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TLDR
The results confirm significantly lower concentrations of stool SCFAs in critically ill patients with sepsis than in control subjects, which may be important in the ICU care protocols of the critical patient.
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The gut microbiota modulation with prebiotics, probiotics and symbiotic suggest improvement in bowel function and maintaining the intestinal environment is key for reducing complications and improving prognosis.
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Dysbiosis of SCFAs‐producing bacteria andSCFAs in AIS patients increased the subsequent risk for poor functional outcomes, indicating that SCFas could be potential prognostic markers and therapeutic targets for stroke.
One Month of Classic Therapeutic Ketogenic Diet Decreases Short Chain Fatty Acids Production in Epileptic Patients
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TLDR
There are many confounding factors that limit the evidence of beneficial effects from fiber supplementation in critically ill patients, including the side effects critical care therapies can have on gut microbiota, but after extrapolating data from healthy and hospitalized non-critical patients and considering that its administration appears to be safe, it may be wise to administer fiber-containing enteral feedings in ICU patients.
Impact of Fiber-Based Enteral Nutrition on the Gut Microbiome of ICU Patients Receiving Broad-Spectrum Antibiotics: A Randomized Pilot Trial
TLDR
Enteral fiber was associated with nonsignificant trends toward increased relative abundance of short-chain fatty acid–producing bacteria and increased short- chain fatty acid levels among ICU patients receiving broad-spectrum IV antibiotics.
Fiber in the ICU: Should it Be a Regular Part of Feeding?
TLDR
The controversy of fiber use in the current critical care nutrition guidelines is highlighted; the effect of fiber on the gut microbiota in the critically ill is reviewed; and the data on fiber and outcomes in the intensive care setting are examined.
Short chain fatty acids and gut microbiota differ between patients with Parkinson's disease and age-matched controls.
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TLDR
An imbalance in the ratio of Bacteroidetes to Firmicutes within seven days from admission was associated with higher mortality when the ratio was > 8 or < 1/8 (odds ratio: 5.54, 95% CI: 1.39–22.18, p = 0.015).
The relationship between enteral nutrition, energy metabolism and gut homeostasis during the course of critical illness
TLDR
The inflammatory response in critically ill children is influenced by the amount of enteral fat and protein delivered, and the data suggests that within the feed delivered, fat is often higher than protein and CHO.
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