The Emerging Role of the Microbiota in the ICU

Nora Suzanne Wolff; Floor Hugenholtz; Willem Joost Wiersinga


Crit Care. 2018;22(78) 

In This Article


The importance of the intestinal and lung microbiotas is often overlooked on the ICU. Currently, we can explore the microbiome using a vast array of techniques, giving us 'meta' libraries of data, which has allowed researchers to show the potential crucial role of the microbiota for ICU patients. During a patient's stay on the ICU, their microbiota is influenced by both their illness and the care provided. For example, the gut microbiota of critically ill patients admitted to the ICU with sepsis is characterized by lower diversity, lower abundance of key commensal genera and, in some cases, an overgrowth by one genera. These changes in the microbiota can, in turn, affect patient outcome and susceptibility to infection. Furthermore, the lung microbiota has only recently been shown to be important in the critically ill. Intriguingly, recent evidence also points to a bi-directional microbiota-mediated role between the gut and the lung, the so called gut-lung axis. The importance of these microbiotas is pushing us towards new types of treatments, in which we also start to treat the microbiota.