During critical illness the gut does not pass the acid test

John C Alverdy

doi:10.1186/cc11474

Abstract

The composition and function of intestinal microflora are emerging as integral to both health and disease. During critical illness the normal microbiota are rapidly replaced by pathogenic species as a result of both the physiologic stress itself and the use of antibiotics. In this report, the authors use fecal pH as a surrogate marker to determine the predictive value of the functional output of the intestinal microflora during critical illness. Fecal pH appears to be highly predictive of outcome from critical illness, and may reflect the output of key organic acids such as the short-chain fatty acids, lactic acid, and other important products of the gut microflora.

Highlights

The composition and function of intestinal microflora are emerging as integral to both health and disease
This work builds on and extends their previous work examining the role of alterations in the intestinal microflora on the systemic immune response syndrome (SIRS) and mortality during critical illness [2]
In the present study the authors demonstrate that when the pH level is increased or decreased by one, the incidence of bacteremia and mortality is increased

Summary

Introduction

The composition and function of intestinal microflora are emerging as integral to both health and disease. In the previous issue of Critical Care, Osuka and colleagues from the Osaka University Hospital and School of Medicine examine fecal pH as a proxy for composition and functional alterations in the gut flora that predict outcome in critically ill patients [1]. This work builds on and extends their previous work examining the role of alterations in the intestinal microflora on the systemic immune response syndrome (SIRS) and mortality during critical illness [2].

Results

Conclusion