The protective effect of probiotics on intestinal mucosal injury and dysbiosis in infants with congenital heart disease undergoing cardiopulmonary bypass

PurposeThis study aimed to investigate alterations in intestinal mucosal barrier function and gut microbiota in pediatric patients with congenital heart disease undergoing cardiopulmonary bypass, and to evaluate whether perioperative probiotic administration improves intestinal homeostasis and clinical outcomes.MethodsA randomized, double-blind, placebo-controlled trial was conducted in infants with non-cyanosis CHD in need of surgical correction with CPB. Infants aged 1 month to 1 year were enrolled between June 2021 and July 2022.

Participants in the treatment group received perioperative probiotics containing Bifidobacterium infantis and Lactobacillus, while patients in control group were supplied with placebo. Clinical outcomes including diarrhea incidence, time to initiation of enteral nutrition and duration of gastrointestinal decompression were recorded.

Blood samples were collected for measurement of intestinal fatty acid-binding protein (IFABP), diamine oxidase (DAO), D-lactate (D-LA), and C-reactive protein (CRP). Fecal samples were obtained to characterize alterations in gut microbiota.ResultsIntestinal mucosal barrier function was impaired after CPB surgery, as evidenced by significant increases in IFABP, DAO, D-LA and CRP levels.