Modifications of lung microbiota structure in traumatic brain injury ventilated patients according to time and enteral feeding formulas: a prospective randomized study

Abstract Background Specialized diets enriched with immune nutrients could be an important supplement in patients (pts) with acute traumatic brain injury (TBI). Omega-3 and arginine may interact with immune response and microbiota. No data are available about the role of the specialized diets in mod...

Full description

Bibliographic Details
Main Authors: A. Cotoia, R. Paradiso, G. Ferrara, G. Borriello, F. Santoro, I. Spina, L. Mirabella, K. Mariano, G. Fusco, G. Cinnella, P. Singer
Format: Article
Language:English
Published: BMC 2023-06-01
Series:Critical Care
Subjects:
Online Access:https://doi.org/10.1186/s13054-023-04531-5
_version_ 1797795647030558720
author A. Cotoia
R. Paradiso
G. Ferrara
G. Borriello
F. Santoro
I. Spina
L. Mirabella
K. Mariano
G. Fusco
G. Cinnella
P. Singer
author_facet A. Cotoia
R. Paradiso
G. Ferrara
G. Borriello
F. Santoro
I. Spina
L. Mirabella
K. Mariano
G. Fusco
G. Cinnella
P. Singer
author_sort A. Cotoia
collection DOAJ
description Abstract Background Specialized diets enriched with immune nutrients could be an important supplement in patients (pts) with acute traumatic brain injury (TBI). Omega-3 and arginine may interact with immune response and microbiota. No data are available about the role of the specialized diets in modulating the lung microbiota, and little is known about the influence of lung microbiota structure in development of ventilator-associated pneumonia (VAP) in TBI pts. The aims of this study are to evaluate the impact of specific nutrients on the lung microbiota and the variation of lung microbiota in TBI pts developing VAP. Methods A cohort of 31 TBI pts requiring mechanical ventilation in ICU was randomized for treatment with specialized (16pts) or standard nutrition (15pts). Alpha and beta diversity of lung microbiota were analyzed from bronco Alveolar Lavage (BAL) samples collected at admission and 7 days post-ICU admission in both groups. A further analysis was carried out on the same samples retrospectively grouped in VAP or no VAP pts. Results None developed VAP in the first week. Thereafter, ten out of thirty-one pts developed VAP. The BAL microbiota on VAP group showed significant differences in beta diversity and Staphylococcus and Acinetobacter Genera were high. The specialized nutrition had influence on beta diversity that reached statistical significance only in Bray–Curtis distance. Conclusion Our data suggest that TBI patients who developed VAP during ICU stay have different structures of BAL microbiota either at admission and at 7 days post-ICU admission, while no correlation has been observed between different enteral formulas and microbiota composition in terms of richness and evenness. These findings suggest that targeting the lung microbiota may be a promising approach for preventing infections in critically ill patients.
first_indexed 2024-03-13T03:21:10Z
format Article
id doaj.art-6d6825e6515040b3af936ecee81091cc
institution Directory Open Access Journal
issn 1364-8535
language English
last_indexed 2024-03-13T03:21:10Z
publishDate 2023-06-01
publisher BMC
record_format Article
series Critical Care
spelling doaj.art-6d6825e6515040b3af936ecee81091cc2023-06-25T11:18:43ZengBMCCritical Care1364-85352023-06-0127111310.1186/s13054-023-04531-5Modifications of lung microbiota structure in traumatic brain injury ventilated patients according to time and enteral feeding formulas: a prospective randomized studyA. Cotoia0R. Paradiso1G. Ferrara2G. Borriello3F. Santoro4I. Spina5L. Mirabella6K. Mariano7G. Fusco8G. Cinnella9P. Singer10Department of Intensive Care, University Hospital of FoggiaDepartment of Animal Health, Istituto Zooprofilattico Sperimentale del MezzogiornoDepartment of Intensive Care, University Hospital of FoggiaDepartment of Animal Health, Istituto Zooprofilattico Sperimentale del MezzogiornoDepartment of Intensive Care, University Hospital of FoggiaDepartment of Intensive Care, University Hospital of FoggiaDepartment of Intensive Care, University Hospital of FoggiaDepartment of Intensive Care, University Hospital of FoggiaDepartment of Animal Health, Istituto Zooprofilattico Sperimentale del MezzogiornoDepartment of Intensive Care, University Hospital of FoggiaIntensive Care Unit Herzlia Médical CenterAbstract Background Specialized diets enriched with immune nutrients could be an important supplement in patients (pts) with acute traumatic brain injury (TBI). Omega-3 and arginine may interact with immune response and microbiota. No data are available about the role of the specialized diets in modulating the lung microbiota, and little is known about the influence of lung microbiota structure in development of ventilator-associated pneumonia (VAP) in TBI pts. The aims of this study are to evaluate the impact of specific nutrients on the lung microbiota and the variation of lung microbiota in TBI pts developing VAP. Methods A cohort of 31 TBI pts requiring mechanical ventilation in ICU was randomized for treatment with specialized (16pts) or standard nutrition (15pts). Alpha and beta diversity of lung microbiota were analyzed from bronco Alveolar Lavage (BAL) samples collected at admission and 7 days post-ICU admission in both groups. A further analysis was carried out on the same samples retrospectively grouped in VAP or no VAP pts. Results None developed VAP in the first week. Thereafter, ten out of thirty-one pts developed VAP. The BAL microbiota on VAP group showed significant differences in beta diversity and Staphylococcus and Acinetobacter Genera were high. The specialized nutrition had influence on beta diversity that reached statistical significance only in Bray–Curtis distance. Conclusion Our data suggest that TBI patients who developed VAP during ICU stay have different structures of BAL microbiota either at admission and at 7 days post-ICU admission, while no correlation has been observed between different enteral formulas and microbiota composition in terms of richness and evenness. These findings suggest that targeting the lung microbiota may be a promising approach for preventing infections in critically ill patients.https://doi.org/10.1186/s13054-023-04531-5Specialized nutritionOmega 3ArginineLung microbiotaAlfa diversityBeta diversity
spellingShingle A. Cotoia
R. Paradiso
G. Ferrara
G. Borriello
F. Santoro
I. Spina
L. Mirabella
K. Mariano
G. Fusco
G. Cinnella
P. Singer
Modifications of lung microbiota structure in traumatic brain injury ventilated patients according to time and enteral feeding formulas: a prospective randomized study
Critical Care
Specialized nutrition
Omega 3
Arginine
Lung microbiota
Alfa diversity
Beta diversity
title Modifications of lung microbiota structure in traumatic brain injury ventilated patients according to time and enteral feeding formulas: a prospective randomized study
title_full Modifications of lung microbiota structure in traumatic brain injury ventilated patients according to time and enteral feeding formulas: a prospective randomized study
title_fullStr Modifications of lung microbiota structure in traumatic brain injury ventilated patients according to time and enteral feeding formulas: a prospective randomized study
title_full_unstemmed Modifications of lung microbiota structure in traumatic brain injury ventilated patients according to time and enteral feeding formulas: a prospective randomized study
title_short Modifications of lung microbiota structure in traumatic brain injury ventilated patients according to time and enteral feeding formulas: a prospective randomized study
title_sort modifications of lung microbiota structure in traumatic brain injury ventilated patients according to time and enteral feeding formulas a prospective randomized study
topic Specialized nutrition
Omega 3
Arginine
Lung microbiota
Alfa diversity
Beta diversity
url https://doi.org/10.1186/s13054-023-04531-5
work_keys_str_mv AT acotoia modificationsoflungmicrobiotastructureintraumaticbraininjuryventilatedpatientsaccordingtotimeandenteralfeedingformulasaprospectiverandomizedstudy
AT rparadiso modificationsoflungmicrobiotastructureintraumaticbraininjuryventilatedpatientsaccordingtotimeandenteralfeedingformulasaprospectiverandomizedstudy
AT gferrara modificationsoflungmicrobiotastructureintraumaticbraininjuryventilatedpatientsaccordingtotimeandenteralfeedingformulasaprospectiverandomizedstudy
AT gborriello modificationsoflungmicrobiotastructureintraumaticbraininjuryventilatedpatientsaccordingtotimeandenteralfeedingformulasaprospectiverandomizedstudy
AT fsantoro modificationsoflungmicrobiotastructureintraumaticbraininjuryventilatedpatientsaccordingtotimeandenteralfeedingformulasaprospectiverandomizedstudy
AT ispina modificationsoflungmicrobiotastructureintraumaticbraininjuryventilatedpatientsaccordingtotimeandenteralfeedingformulasaprospectiverandomizedstudy
AT lmirabella modificationsoflungmicrobiotastructureintraumaticbraininjuryventilatedpatientsaccordingtotimeandenteralfeedingformulasaprospectiverandomizedstudy
AT kmariano modificationsoflungmicrobiotastructureintraumaticbraininjuryventilatedpatientsaccordingtotimeandenteralfeedingformulasaprospectiverandomizedstudy
AT gfusco modificationsoflungmicrobiotastructureintraumaticbraininjuryventilatedpatientsaccordingtotimeandenteralfeedingformulasaprospectiverandomizedstudy
AT gcinnella modificationsoflungmicrobiotastructureintraumaticbraininjuryventilatedpatientsaccordingtotimeandenteralfeedingformulasaprospectiverandomizedstudy
AT psinger modificationsoflungmicrobiotastructureintraumaticbraininjuryventilatedpatientsaccordingtotimeandenteralfeedingformulasaprospectiverandomizedstudy