Objective:

To investigate alterations in intestinal mucosal barrier function and gut microbiota in pediatric patients with congenital heart disease undergoing cardiopulmonary bypass, and to evaluate the effects of perioperative probiotic administration on clinical outcomes such as diarrhea incidence and enteral nutrition initiation time.

Key Findings:

• Intestinal mucosal barrier function was impaired post-CPB, indicated by increased levels of IFABP, DAO, D-LA, and CRP.
• Probiotics led to significantly lower levels of IFABP and DAO in the treatment group compared to controls (p < 0.05).
• Probiotic administration resulted in earlier initiation of enteral feeding (mean difference X days) but did not significantly affect diarrhea incidence or gastrointestinal decompression duration.
• Probiotics altered the baseline microbial community structure and partially mitigated CPB-induced dysbiosis.

Interpretation:

Probiotics may help alleviate intestinal injury and dysbiosis in infants with congenital heart disease undergoing cardiopulmonary bypass, suggesting a potential therapeutic role that could improve clinical outcomes.

Limitations:

• The study had a limited sample size, which may restrict the generalizability of the findings.
• No significant differences were found for D-LA and CRP levels between groups, indicating the need for further investigation.

Conclusion:

Probiotic administration may improve intestinal homeostasis and clinical outcomes in infants with CHD undergoing CPB, warranting further research with larger cohorts to validate these findings.