Introduction: Nutritional support generates complications that must be detected and treated on time. Objective: To estimate the incidence of some complications of nutritional support in patients admitted to general hospital wards who received nutritional support in six high-complexity institutions. Methods: Prospective, descriptive and multicentric study in patients with nutritional support; the variables studied were medical diagnosis, nutritional condition, nutritional support duration, approach, kind of formula, and eight complications. Results: A total of 277 patients were evaluated; 83% received enteral nutrition and 17% received parenteral nutrition. Some 69.3% presented risk of malnourishment or severe malnourishment at admittance. About 35.4% of those receiving enteral nutrition and 39.6% of the ones who received parenteral nutrition had complications; no significant difference per support was found (p = 0.363). For the enteral nutrition, the most significant complication was the removal of the catheter (14%), followed by diarrhea (8.3%); an association between the duration of the enteral support with diarrhea, constipation and removal of the catheter was found (p < 0.05). For parenteral nutrition, hyperglycemia was the complication of highest inci­dence (22.9%), followed by hypophosphatemia (12.5%); all complications were associated with the duration of the support (p < 0.05). Nutritional support was suspended in 24.2% of the patients. Conclusions: Complications with nutritional support in hospital-ward patients were frequent, with the removal of the catheter and hyperglycemia showing the highest incidence. Duration of the support was the variable that revealed an asso­ciation with complications. Strict application of protocols could decrease the risk for complications and boost nutritional support benefits.

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ResumenAntecedentes: diversos estudios han mostrado cambios en la microbiota intestinal (MI) y los áci-dos grasos de cadena corta (AGCC) en pacientes críticos con síndrome de respuesta inflamatoria sistémica (SRIS). Objetivo: revisar la evidencia sobre el papel de la MI y los AGCC en pacientes críticos y su modulación con prebióticos, probióticos y simbióticos. Materiales y métodos: búsque-da de artículos en bases de datos bibliográficas Pubmed, Science Direct, Ovid, Medline y Scopus, utilizando como descriptores microbiota, paciente crítico, unidad de cuidados intensivos, síndrome de respuesta inflamatoria sistémica, ácidos grasos de cadena corta, probióticos, prebióticos y simbióticos. Resultados: la MI en pacientes críticos está disminuida tanto en número de bacterias como en diversidad, lo cual puede resultar en una desregulación de la respuesta inmune sistémica ante la invasión de microorganismos patógenos. Los cambios en los AGCC en pacientes críticos se atribuyen a una disminución de bacterias anaerobias obligadas y sustratos de fermentación necesarios para su producción. La modulación de la MI con probióticos, prebióticos y simbióticos sugiere mejoría en la función intestinal. Conclusiones: la MI y los AGCC en pacientes críticos se encuentran alterados, de ahí que mantener el equilibrio en el entorno intestinal probablemente desempeñe una función clave para disminuir complicaciones y mejorar su pronóstico.Palabras clave: paciente crítico, microbiota, ácidos grasos de cadena corta, síndrome de respuesta inflamatoria sistémica, probióticos, prebióticos, simbióticos. Gut Microbiota and Short-Chain Fatty Acids in Critically Ill Patients AbstractBackground: Different studies have shown changes in gut microbiota and short-chain fatty acids in critically ill patients with Systemic Inflammatory Response Syndrome (SIRS). Aim: To review the evidence about the role of gut microbiota and SCFAs in critically patients and its modulation with prebiotics, probiotics and symbiotic. Materials and Methods: A search of the literature in Pubmed, Science Direct, Ovid, Medline and Scopus databases was conducted. The terms used were microbiota, critically ill, intensive care unit, systemic inflammatory response syndrome, short-chain fatty acids, prebiotics, probiotics and symbiotic. Results: The intestinal microbiota in critically ill patients is reduced in number and diversity, which can lead to dysregulation of the systemic immune response to the pathogenic invasion. Changes in SCFAs in critically ill patients are attributed to a decrease of obligate anaerobic bacteria and the fermentation substrates required for its production. The gut microbiota modulation with prebiotics, probiotics and symbiotic suggest improvement in bowel function. Conclusions: Gut microbiota and SCFAs are altered in critically ill patients; therefore, maintaining the intestinal environment is key for reducing complications and improving prognosis.

ResumenLos animales cuando nacen no presentan bacterias en su tracto digestivo, este va adquiriendo múltiples bacterias de su entorno las cuales que se establecen y permanecen durante las diferentes las etapas de su vida, muchas de estas bacterias están ligadas a la alimentación del animal, ejercen diferentes acciones benéficas, colonizan y logran ser parte de la flora natural del animal. Con el objeto de estudiar parte de esta diversidad microbiana y su efecto en lechones (Sus scrofa domesticus), se aislaron, identificaron y caracterizaron bacterias cultivables asociadas al tracto digestivo del lechón como las Bacteria acido láctica BAL, la identificación se realizó mediante caracterización bioquímica encontrando 39 y 35 bacterias cultivables aisladas de diferentes regiones del tracto digestivo de dos lechones provenientes del estómago, duodeno, yeyuno e íleon del intestino delgado y además del ciego, colon y recto, para la acción BAL se descartaron bioquímicamente, quedando 9 y 15, se identificaron molecularmente 8 bacterias con secuencias conservadas del gen 16S ARNr encontrando semejanzas genéticas entre ellos para Bacillus fermentus y 01 Lactococus lactis, todas conocidos como bacterias ácido lácticas con efecto benéfico para la industria alimentaria.Palabras clave: bacterias; acido lácticas; lechones; microbiología molecular; BAL. AbstractThe animals when they are born do not present bacteria in their digestive tract, this one is acquiring multiple bacteria of its surroundings which settle down and remain during the different stages of its life, many of these bacteria are linked to the animal's food, they exercise different beneficial actions, they colonize and they become part of the animal's natural flora. In order to study part of this microbial diversity and its effect on piglets (Sus scrofa domesticus), Isolates, identified and characterized cultivable bacteria associated with the digestive tract of suckling pig such as lactic acid bacteria BAL, The identification was made by biochemical characterization by finding 39 and 35 cultivable bacteria isolated from different regions of the digestive tract of two piglets from the stomach, duodenum, jejunum and ileum of the small intestine and in addition to the cecum, colon and rectum, for BAL action were discarded biochemically, leaving 9 and 15, molecularly 8 bacteria were identified with conserved sequences of the 16S rRNA Finding genetic similarities between them for Bacillus fermentus and 01 Lactococus lactis, all known as lactic acid bacteria with beneficial effect for the food industry.