Exploring choices of early nutritional support for patients with sepsis based on changes in intestinal microecology

作     者：Xiao-Juan Yang Xiao-Hong Wang Ming-Yue Yang Hong-Yan Ren Hui Chen Xiao-Ya Zhang Qin-Fu Liu Ge Yang Yi Yang Xiao-Jun Yang 

作者机构：Department of Critical Care MedicineGeneral Hospital of Ningxia Medical UniversityYinchuan 750004Ningxia Hui Autonomous RegionChina School of Clinical MedicineNingxia Medical UniversityYinchuan 750004Ningxia Hui Autonomous RegionChina Department of Emergency MedicineAffiliated Hospital of Jining Medical UniversityJining 272030Shandong ProvinceChina Shanghai Mobio Biomedical Technology Co.Ltd.Shanghai 201318China Department of Critical Care MedicineSoutheast University School of MedicineZhongda HospitalSchool of MedicineSoutheast UniversityNanjing 210009Jiangsu ProvinceChina 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2023年第29卷第13期

页      面：2034-2049页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100401[医学-流行病与卫生统计学] 10[医学] 

基　　金：Supported by Ningxia Natural Science Foundation Project,No.2022AAC03488 the National Key Research and Development Program of China,No.2016YFD0400605 

主　　题：Sepsis Nutritional support Intestinal microecology Short-chain fatty acids Nutritional and immunological indicators Total enteral nutrition Total parenteral nutrition Supplemental parenteral nutrition 

摘      要：BACKGROUND Sepsis exacerbates intestinal microecological disorders leading to poor *** modalities of nutritional support can improve nutrition,immunity,and intestinal *** To identify the optimal modality of early nutritional support for patients with sepsis from the perspective of intestinal *** Thirty patients with sepsis admitted to the intensive care unit of the General Hospital of Ningxia Medical University,China,between 2019 and 2021 with indications for nutritional support,were randomly assigned to one of three different modalities of nutritional support for a total of 5 d:Total enteral nutrition(TEN group),total parenteral nutrition(TPN group),and supplemental parenteral nutrition(SPN group).Blood and stool specimens were collected before and after nutritional support,and changes in gut microbiota,short-chain fatty acids(SCFAs),and immune and nutritional indicators were detected and compared among the three *** In comparison with before nutritional support,the three groups after nutritional support presented:(1)Differences in the gut bacteria(Enterococcus increased in the TEN group,Campylobacter decreased in the TPN group,and Dialister decreased in the SPN group;all P0.05);(2)different trends in SCFAs(the TEN group showed improvement except for Caproic acid,the TPN group showed improvement only for acetic and propionic acid,and the SPN group showed a decreasing trend);(3)significant improvement of the nutritional and immunological indicators in the TEN and SPN groups,while only immunoglobulin G improved in the TPN group(all P0.05);and(4)a significant correlation was found between the gut bacteria,SCFAs,and nutritional and immunological indicators(all P0.05).CONCLUSION TEN is recommended as the preferred mode of early nutritional support in sepsis based on clinical nutritional and immunological indicators,as well as changes in intestinal microecology.