The importance of the intestinal and lung microbiotas is often overlooked on the ICU. Currently, we can explore the microbiome using a vast array of techniques, giving us ‘meta’ libraries of data, which has allowed researchers to show the potential crucial role of the microbiota for ICU patients. During a patient’s stay on the ICU, their microbiota is influenced by both their illness and the care provided. For example, the gut microbiota of critically ill patients admitted to the ICU with sepsis is characterized by lower diversity, lower abundance of key commensal genera and, in some cases, an overgrowth by one genera.

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