Prebióticos, probióticos y simbióticos en la dietoterapia de los pacientes quemados

the composition of the gastrointestinal tract microflora is essential to maintain the barrier function. this is altered in burn patients immediately after suffering the injury and the consequential increase in intestinal permeability entails a greater possibility of uncontrolled infections that can lead to death in these immunocompromised patients. functional foods with pre-, pro-and synbiotics emerge as a therapeutic strategy consisting in biological immunomodulators that limit the development and translocation of pathogenic bacteria and endotoxins, as well as nosocomial infection and systemic inflammatory response of intestinal origin. the aim of this review is to describe the phenomenon of bacterial translocation and the alteration of intestinal mucosa's permeability in burn patients, and to recognize the functional foods and nutritional products with pre-, pro-and synbiotic effect that would be more adequate to offer in due time. the mechanisms that favor translocation are: the loss of barrier function, the modification of bacteria content in the intestinal lumen and the impaired host immune defenses. prebiotics can bring about gastrointestinal symptoms which are secondary to the osmotic effect and fermentation in the intestinal lumen. the use of bacteriotherapy with probiotics and synbiotics needs a judicious consideration of the potential adverse effects of certain bacterial strains, such as infections due to transmigration and dlactate acidosis. the experience in treating burn patients with foods and nutritional products having a pre-, pro-or synbiotic function is still not enough to make recommendations on their consumption and even less as regards those products available in the market.