Probiotics' Role in Mitigating Intestinal Mucosal Damage in Infants with CHD

Overview

Revise to specify the implications of the findings on biomarkers of intestinal injury.

Background

Congenital heart disease (CHD) is the most common congenital malformation and poses significant risks for intestinal mucosal injury and dysbiosis, particularly during surgical interventions like CPB. The gut microbiota plays a crucial role in maintaining intestinal health, and its disruption can lead to severe complications, including necrotizing enterocolitis. Understanding the role of probiotics in this context is essential for improving clinical outcomes in affected infants.

Data Highlights

Key Findings

• Probiotics improved intestinal barrier function as indicated by lower IFABP and DAO levels post-surgery.
• Probiotic administration allowed for earlier initiation of enteral feeding compared to placebo.
• No significant differences were observed in D-lactate and CRP levels between the treatment and control groups.
• CPB surgery led to increased levels of opportunistic pathogens and decreased beneficial microbiota.
• Probiotics partially mitigated the dysbiosis induced by CPB.

Clinical Implications

The findings suggest that perioperative probiotics may be beneficial in managing intestinal health in infants with CHD undergoing CPB. Clinicians should consider the use of probiotics to potentially enhance recovery and reduce intestinal complications in this vulnerable population.

Conclusion

Highlight the necessity for larger studies and specify which outcomes should be validated.

References

1. Pediatric Cardiology, GuMiBear Study, 2024 -- The Role of Gut Microbiota in Pediatric Patients with Congenital Heart Disease Following Cardiopulmonary Bypass Surgery
2. Pediatric Cardiology, 2024 -- Necrotizing Enterocolitis in Pediatric Patients with Congenital Heart Defects: A Review of Current Literature
3. Dysbiosis and Intestinal Barrier Dysfunction in Pediatric Congenital Heart Disease Is Exacerbated Following Cardiopulmonary Bypass, ScienceDirect, 2021
4. Investigation of Serum Levels of miR-21-5p, miR-135-5p, and miR-155-5p in Patients Administered Bifidobacterium triplex Viable Capsules During the Perioperative Period of Colorectal Cancer
5. Pediatric Cardiology — Effects of Tailored Cardiopulmonary Bypass Management on Kidney Function and Hospital Outcomes in Pediatric Cardiac Surgery: A Preliminary Investigation
6. Dysbiosis and Intestinal Barrier Dysfunction in Pediatric Congenital Heart Disease Is Exacerbated Following Cardiopulmonary Bypass - ScienceDirect
7. https://academic.oup.com/ejcts/article-abstract/65/4/ezae152/7643516
8. Perioperative Care in Cardiac Surgery: A Joint Consensus Statement by the Enhanced Recovery After Surgery (ERAS) Cardiac Society, ERAS International Society, and The Society of Thoracic Surgeons (STS) | CTSNet