Probiotics may alleviate intestinal damage induced by cardiopulmonary bypass in children.

Intestinal ischaemia-reperfusion injury induced by cardiopulmonary bypass causes intestinal epithelial barrier dysfunction, leading to dysbiosis and bacterial translocation. We conducted a randomized prospective study with 2 objectives: (i) to investigate epithelial barrier dysfunction and bacterial translocation induced by cardiopulmonary bypass and changes in the gut microbiota and (ii) to verify whether probiotics can improve these conditions. Between 2019 and 2020, patients 0-15 years old scheduled to undergo cardiac surgery using cardiopulmonary bypass were enrolled and randomly allocated to 2 groups: the intervention group received probiotics and the control group did not receive probiotics. We analysed the microbiota in faeces and blood, organic acid concentrations in faeces, plasma intestinal fatty acid-binding protein and immunological responses. Eighty-two patients were enrolled in this study. The characteristics of the patients were similar in both groups. The total number of obligate anaerobes was higher in the intervention group than in the control group after postoperative day 7. We identified 4 clusters within the perioperative gut microbiota, and cluster changes showed a corrective effect of probiotics on dysbiosis after postoperative day 7. Organic acid concentrations in faeces, incidence of bacterial translocation, intestinal fatty acid-binding protein levels and immunological responses, except for interleukin -17A, were not markedly different between the 2 groups. Administration of probiotics was able to correct dysbiosis but did not sufficiently alleviate the intestinal damage induced by cardiopulmonary bypass. More effective methods should be examined to prevent disturbances induced by cardiac surgery using cardiopulmonary bypass. https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000037174 UMIN000035556.

Toritsuka D ，Aoki M ，Higashida A ，Fukahara K ，Nishida N ，Hirono K ，Hane M ，Sugimoto T ，Asahara T ，Yoshimura N ... -  《-》

Feeding intolerance after pediatric cardiac surgery is associated with dysbiosis, barrier dysfunction, and reduced short-chain fatty acids.

Owens J ，Qiu H ，Knoblich C ，Gerjevic L ，Izard J ，Xu L ，Lee J ，Kollala SS ，Murry DJ ，Riethoven JJ ，Davidson JA ，Singh AB ，Ibrahimiye A ，Ortmann L ，Salomon JD ... -  《-》

Probiotics can alleviate cardiopulmonary bypass-induced intestinal mucosa damage in rats.

Sun YJ ，Cao HJ ，Song DD ，Diao YG ，Zhou J ，Zhang TZ ... -  《-》

Clinical characteristics associated with postoperative intestinal epithelial barrier dysfunction in children with congenital heart disease.

Typpo KV ，Larmonier CB ，Deschenes J ，Redford D ，Kiela PR ，Ghishan FK ... -  《Pediatric Critical Care Medicine》

Probiotics might relieve intestinal impairment caused by cardiopulmonary bypass in children.

Li L 《-》