Changes in Gastrointestinal Homeostasis in Critically Ill Children
Research type
Research Study
Full title
Investigation of the role of gut failure in the pathophysiology of multiorgan dysfunction in paediatric critical illness
IRAS ID
127185
Contact name
Nazima Pathan
Contact email
Sponsor organisation
Cambridge University Hospitals NHS Foundation Trust and the University of Cambridge
Research summary
Critical illness represents the most complex derangement of cellular and organ function, and consumes a large portion of the NHS budget. Children may be admitted to the intensive care unit for a number of reasons, including following major surgery, due to severe infection and trauma. A common feature that drives the development of multiple organ failure in these children is the dysregulation of mechanisms that normally maintain cellular, metabolic and immune function. As a result, children may require support of vital functions including administering ventilation, drugs to improve cardiac contraction, intravenous feeds to maintain nutrition if the gut is not working and dialysis to support kidney function. All these functions whilst they may support organ function until recovery, do not improve the process of resolution. Furthermore, all these therapies are invasive and are associated with secondary complications such as hospital acquired infection.
During critical illness we know that there is disruption to the delicate balance between the gut and the rest of the body. The gut contains billions of bacteria that in health have an important and positive relationship with the host. The normal gut bacteria receive a nutrient-rich environment from the host and in turn are beneficial in aiding intestinal immune, metabolic and digestive functions. During critical illness there is increasing evidence that depletion of these bacterial populations and disruption of the gut lining mean that bacterial fragments may enter the bloodstream from the gut and worsen the severity of inflammation and multi-organ dysfunction.REC name
London - Bromley Research Ethics Committee
REC reference
13/LO/0974
Date of REC Opinion
25 Jun 2013
REC opinion
Further Information Favourable Opinion