When a child becomes critically ill, or is seriously injured in an accident, the clinicians fighting to save their life will often prescribe strong medication that is absolutely vital – perhaps to support the heart function - but this can have serious side effects. In these critical situations, children’s systems are also fighting to restore balance, plus recover from shock and their immune responses can go into overdrive. 

The combination of an over-reaction in the immune system and powerful drugs can be catastrophic for the billions of bacteria in the gut, especially when a child needs to be tube-fed and the gut is effectively starved, even while the patient has essential nourishment. This can be a matter of life and death – damage to the gut lining can cause secondary infection and organ failure, plus the interdependency of the immune system and healthy gut bacteria may impact on long term recovery. 

Since 2014 the Evelyn Trust has been funding a University of Cambridge research project at Addenbrooke’s Hospital that examines these complex issues and tries to determine the nature of the relationship between gut health and recovery. Funding over the last two years has secured a research assistant who has been working with critically ill children in the Paediatric Intensive Care Unit, analysing blood, urine and stool samples for short-chain fatty acids and other inflammatory ‘biomarkers’. She has also been recording comprehensive data on disease severity, medication, feeding, nutrition and growth to build a complete picture of the health of the children taking part in the study. Samples and data have also been taken from healthy children as controls. The project is due to complete early in 2017 following six months of intensive data analysis.

Dr Nazima Pathan, Consultant and Lecturer at the University of Cambridge and Principal Investigator for this project, explains what impact this research could have on treatment.

“Once we understand more about the impact of critical illness on the gut, we should then be able to make informed decisions that will enable more rapid recovery. This could include the use of prebiotic, probiotic or other nutritional supplements to speed up the recovery of the digestive system by encouraging the growth of healthy bacteria, or halt the deterioration of a child’s gut health. We will also have more knowledge about which illnesses and medication have the most severe impact on the gut and be able to target the patients likely to be most at risk with effective treatment at an earlier stage. We’re so grateful to the Evelyn Trust for their support as we believe that our work will save children’s lives.”