FMT for Feeding Intolerance Due to Gastrointestinal Dysfunction in Critically Ill Patients

Critically ill patients admitted to the intensive care unit (ICU) frequently present withgastrointestinal dysfunction and are at elevated risk of malnutrition. Gastrointestinaldysfunction is correlated with adverse clinical outcomes, including prolonged mechanicalventilation duration, extended ICU length of stay, and increased 90‐day mortality.In critically ill ICU patients, severe gut microbiota dysbiosis and intestinal barrierimpairment may occur due to the burden of primary critical illnesses, as well as theadministration of proton pump inhibitors and antibiotics. This cascade contributes to ahigh prevalence of gastrointestinal dysfunction, alongside profound gut‐derived systemicinflammatory responses and organ damage. Given the pivotal role of gut microbiota inmaintaining intestinal homeostasis, fecal microbiota transplantation (FMT) holds promiseas a novel therapeutic strategy for enteral feeding intolerance secondary togastrointestinal dysfunction in critically ill ICU patients.This study intends to deliver FMT via a nasojejunal tube to critically ill patients withgastrointestinal dysfunction admitted to the ICU. Its objectives are to evaluate theintervention's effects on gastrointestinal function recovery and the alleviation ofenteral feeding intolerance, while also assessing its impacts on intestinal barrierfunction, gut microbiota composition and metabolic profiles, serum metabolite signatures,immune‐inflammatory responses (including lymphocyte subsets, cytokines, C‐reactiveprotein, and procalcitonin), ICU delirium, ICU sleep quality, and clinical outcomes(encompassing ICU mortality, in‐hospital mortality, 28‐day all‐cause mortality, 90‐dayall‐cause mortality, 90‐day readmission rate, and 90‐day incidence of secondaryinfections).