While stool transplantation has medical attention and has been rather successfully applied in a few chronic diseases, it seems difficult to apply during critical illnesses (ICU). Microbiome manipulation in ICU patients requires a novel approach.
During the early phase of acute illness, the goal would be the maintenance of a physiologic mass of beneficial bacteria and yeasts by the administration of new nutrition products. After this first period, the goal will be to optimize the gut microbiome by a revolutionary feed capable to nourish the microbes and only to marginally contribute to feeding the host. In this approach, enteral nutrition would aim at feeding the intestinal microbiome, whereas parenteral nutrition would secure the optimal provision of nutrients patient.