Observational studyThe journal of trauma and acute care surgery2019
A prospective study in severely injured patients reveals an altered gut microbiome is associated with transfusion volume.
Observational study in The journal of trauma and acute care surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- The Gut-Iron-Immune Axis in Severe Anaemia and Bacteraemia.Nutrients · 2026Review
- Gastrointestinal Dysfunction in Critically Ill Patients With Traumatic Brain Injury: Clinical Implications and Putative Mechanisms: a Narrative Review.Current neurology and neuroscience reports · 2026Review
- Friend or foe: the gut microbiota as a modulator of disease trajectory in trauma, surgery, and critical illness.Gut microbes · 2025Review
- A multi-omics approach exploring the gut-liver axis following combined radiation exposure and burn injury in a Sinclair minipig model.Scientific reports · 2025Article
- Diversity of intestinal microbiota and inflammatory cytokines after severe trauma.Scientific reports · 2025Article
- Nonselective beta blockade enhances gut microbiome diversity in a rodent model of trauma, hemorrhage, and chronic stress.The journal of trauma and acute care surgery · 2025Article
- Metagenomic changes in response to antibiotic treatment in severe orthopedic trauma patients.iScience · 2024Article
- Lung Protection After Severe Thermal Burns With Adenosine, Lidocaine, and Magnesium (ALM) Resuscitation and Importance of Shams in a Rat Model.Journal of burn care & research : official publication of the American Burn Association · 2024Article
- Research progress on digestive disorders following traumatic brain injury.Frontiers in immunology · 2024Review
- Radiation-induced multi-organ injury.International journal of radiation biology · 2024Article
- Article
- The Intestinal Microbiome after Traumatic Injury.Microorganisms · 2023Review
- Dysbiome and Its Role in Surgically Relevant Medical Disease.Surgical infections · 2023Review
- Fecal microbiota of horses with colitis and its association with laminitis and survival during hospitalization.Journal of veterinary internal medicine · 2022Article
- Small animal models of thermal injury.Methods in cell biology · 2022Review
- Stress-related changes in the gut microbiome after trauma.The journal of trauma and acute care surgery · 2021Article
- The Brain-gut Axis-where are we now and how can we Modulate these Connections?Current neuropharmacology · 2021Article
- Burn resuscitation strategy influences the gut microbiota-liver axis in swine.Scientific reports · 2020Article
- The gut microbiome distinguishes mortality in trauma patients upon admission to the emergency department.The journal of trauma and acute care surgery · 2020Observational
- MicroRNA Profiling of Exosomes Derived from Red Blood Cell Units: Implications in Transfusion-Related Immunomodulation.BioMed research international · 2019Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
backgroundTraumatic injury can lead to a compromised intestinal epithelial barrier and inflammation. While alterations in the gut microbiome of critically injured patients may influence clinical outcomes, the impact of trauma on gut microbial composition is unknown. Our objective was to determine if the gut microbiome is altered in severely injured patients and begin to characterize changes in the gut microbiome due to time and therapeutic intervention.
methodsWe conducted a prospective, observational study in adult patients (n = 72) sustaining severe injury admitted to a Level I Trauma Center. Healthy volunteers (n = 13) were also examined. Fecal specimens were collected on admission to the emergency department and at 3, 7, 10, and 13 days (±2 days) following injury. Microbial DNA was isolated for 16s rRNA sequencing, and α and β diversities were estimated, according to taxonomic classification against the Greengenes database.
resultsThe gut microbiome of trauma patients was altered on admission (i.e., within 30 minutes following injury) compared to healthy volunteers. Patients with an unchanged gut microbiome on admission were transfused more RBCs than those with an altered gut microbiome (p < 0.001). Although the gut microbiome started to return to a β-diversity profile similar to that of healthy volunteers over time, it remained different from healthy controls. Alternatively, α diversity initially increased postinjury, but subsequently decreased during the hospitalization. Injured patients on admission had a decreased abundance of traditionally beneficial microbial phyla (e.g., Firmicutes) with a concomitant decrease in opportunistic phyla (e.g., Proteobacteria) compared to healthy controls (p < 0.05). Large amounts of blood products and RBCs were both associated with higher α diversity (p < 0.001) and a β diversity clustering closer to healthy controls.
conclusionThe human gut microbiome changes early after trauma and may be aided by early massive transfusion. Ultimately, the gut microbiome of trauma patients may provide valuable diagnostic and therapeutic insight for the improvement of outcomes postinjury. LEVEL OF EVIDENCE: Prognostic and Epidemiological, level III.
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