Pacientes sépticos e modulação da microbiota intestinal: uma revisão de escopo

Yuri Carvalho; Nayeli Silva Lima Matias; André Nilson Nogueira Freitas; Renata Carmo de Assis

doi:10.52521/nutrivisa.v12i1.16219

Authors

Yuri Carvalho UECE https://orcid.org/0009-0009-2921-0654
Nayeli Silva Lima Matias Universidade Estadual do Ceará (UECE), Fortaleza-Ce, Brasil https://orcid.org/0009-0002-3198-9707
André Nilson Nogueira Freitas Universidade Estadual do Ceará (UECE), Fortaleza-Ce, Brasil https://orcid.org/0009-0007-0458-3871
Renata Carmo de Assis Universidade Estadual do Ceará (UECE), Fortaleza-Ce, Brasil, https://orcid.org/0000-0003-2258-3844

DOI:

https://doi.org/10.52521/nutrivisa.v12i1.16219

Abstract

Sepsis is a severe condition characterized by life-threatening organ dysfunction resulting from a dysregulated host response to infection, with high mortality rates and significant healthcare costs, especially in low- and middle-income countries. Metabolic and inflammatory disturbances frequently compromise intestinal function, promote dysbiosis, and increase the risk of infectious complications, making early enteral nutrition an essential strategy to preserve the gut barrier, modulate immune-metabolic responses, and provide clinical support. This study aimed to map the available evidence on gut microbiota modulation through enteral dietary interventions in septic patients. A descriptive scoping review was conducted following the Joanna Briggs Institute and PRISMA-ScR guidelines. Database searches identified 235 publications, of which six met eligibility criteria, including five clinical trials and one observational study conducted between 2021 and 2025. Findings indicate that critically ill septic patients present gut microbiota with markedly low diversity and predominance of opportunistic pathogens. Enteral nutrition demonstrated potential in preserving intestinal integrity and improving immunological parameters, whereas fibers, prebiotics, probiotics, and synbiotics showed promising but heterogeneous and limited results. Major limitations across studies included small sample sizes, short follow-up periods, and lack of methodological standardization. In conclusion, early enteral nutrition plays a central role in the management of septic patients; however, the effectiveness of interventions targeting gut microbiota modulation remains insufficiently supported. Further large-scale, multicenter trials with standardized clinical and microbiological outcomes are needed to consolidate evidence and guide more consistent clinical recommendations.

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