Major Trauma and Microbiome
By Ross Pelton, RPh, PhD, CCN
Authors of a recently published study report that serious injury/trauma cause major detrimental changes in the gut microbiome within 72 hours. These changes may influence a patient’s chances of recovery or death, and understanding these changes might help physicians stave off critical illness, according to the study’s authors.
The authors collected stool samples from 12 critically injured patients (ages 20-85) immediately after being admitted to a major trauma center. Stool samples were again taken 24 and 72 hours after admission. The trauma patient’s stool samples were compared with stool samples from 10 patients at the same trauma center who were not seriously injured and did not require intensive care.
The initial samples from both groups revealed comparable numbers and types of gut bacteria, but substantial differences were noticed by the time the second sample was taken after 24 hours. After 72 hours, the samples from the trauma patients showed a decline in some lesser known bacteria along with a corresponding increase in potentially pathological species, notably clostridia and enterococci.
The researchers stated the following: “The short time course in which such alterations occur is also notable—such relatively rapid alterations in intestinal microbiota represent a critical and previously unrecognized phenomenon that may influence clinical course and outcomes after severe trauma.”
The authors also referred to other relevant research, which suggests that critical illness may be linked to clinically relevant changes in a patient’s microbiome. Also, recent research in burn injury in both animal models and humans, suggests that major changes in the composition of the microbiome may be associated with a heightened risk of sepsis.
Because the gut microbiome is known to modulate inflammation, trauma-associated changes in the composition and number of gut bacteria may indeed influence the clinical outcomes in patients who are critically ill.
In their conclusion, the authors stated, “Implementing a probiotic regimen or guiding the microbial composition changes after trauma might prove a powerful tool in the critical care arsenal. Though causal relationships remain to be determined, a better understanding of the nature of these post injury changes may lead to the ability to intervene in otherwise pathological clinical trajectories.”
Hopefully this research will create an opportunity for certain probiotics to play a role in supporting the immune system & recovery of patients who have experienced serious injury and/or trauma.
Howard BM, et al. Characterizing the gut microbiome in trauma: significant changes in microbial diversity occur early after severe injury. Trauma Surgery & Acute Care Open. 23 Oct 2017;2:1-6.