胃肠病学
内科学
医学
全身炎症反应综合征
菌血症
肠外营养
双歧杆菌
肠道菌群
败血症
乳酸菌
免疫学
生物
微生物学
细菌
抗生素
遗传学
作者
Kentaro Shimizu,Hiroshi Ogura,Takashi Asahara,Koji Nomoto,Masami Morotomi,Yasutaka Nakahori,Akinori Osuka,Shuhei Yamano,Miki Goto,Asako Matsushima,Osamu Tasaki,Yasuyuki Kuwagata,Hisashi Sugimoto
标识
DOI:10.1111/j.1365-2982.2010.01653.x
摘要
The gut is an important target organ for injury after severe insult, and resolution of feeding intolerance is crucial for critically ill patients. We investigated gut flora and motility to evaluate the impact of gastrointestinal dysmotility on septic complications in patients with severe systemic inflammatory response syndrome (SIRS).Sixty-three ICU patients with severe SIRS were divided into two groups depending on their intestinal condition. Patients with feeding intolerance comprised patients who had feeding intolerance, defined as ≥ 300 mL reflux from nasal gastric feeding tube in 24 h, and patients without feeding intolerance comprised patients with no feeding intolerance. We compared fecal microflora, incidences of bacteremia, and mortality between these groups.Analysis of feces showed that patients with feeding intolerance had significantly lower numbers of total obligate anaerobes including Bacteroidaceae and Bifidobacterium, higher numbers of Staphylococcus, lower concentrations of acetic acid and propionic acid, and higher concentrations of succinic acid and lactic acid than those in patients without feeding intolerance (P ≤ 0.05). Patients with feeding intolerance had higher incidences of bacteremia (86%vs 18%) and mortality (64%vs 20%) than did patients without feeding intolerance (P ≤ 0.05).Gut flora and organic acids were significantly altered in patients with severe SIRS complicated by gastrointestinal dysmotility, which was associated with higher septic mortality in SIRS patients.
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