Synbiotics modulate gut microbiota and reduce enteritis and ventilator-associated pneumonia in patients with sepsis: a randomized controlled trial

Autor: Takeshi Shimazu, Hiroshi Ogura, Masahiro Ojima, Tomomi Yamada, Mitsunori Ikeda, Kentaro Shimizu, Tomoki Yamada, Takashi Asahara, Satoshi Fujimi, Takeyuki Kiguchi, Tomoyoshi Mohri
Rok vydání: 2017
Předmět:
0301 basic medicine
Male
Letter
Synbiotics
Gut flora
Critical Care and Intensive Care Medicine
Gastroenterology
law.invention
law
Gut
Prospective Studies
APACHE
Aged
80 and over
biology
Microbiota
Incidence
lcsh:Medical emergencies. Critical care. Intensive care. First aid
Ventilator-associated pneumonia
Pneumonia
Ventilator-Associated
Middle Aged
Intensive care unit
Enteritis
Diarrhea
Lacticaseibacillus casei
Female
medicine.symptom
medicine.medical_specialty
Critical Illness
030106 microbiology
Sepsis
Short-chain fatty acids
03 medical and health sciences
Internal medicine
medicine
Humans
Aged
Proportional Hazards Models
business.industry
Probiotics
lcsh:RC86-88.9
medicine.disease
biology.organism_classification
Gastrointestinal Microbiome
030104 developmental biology
Bacteremia
Bifidobacterium bifidum
business
Zdroj: Critical Care
Critical Care, Vol 22, Iss 1, Pp 1-9 (2018)
ISSN: 1466-609X
Popis: Background Commensal microbiota deteriorate in critically ill patients. The preventive effects of probiotic/synbiotic therapy on microbiota and septic complications have not been thoroughly clarified in patients with sepsis. The objective of this study was to evaluate whether synbiotics have effects on gut microbiota and reduce complications in mechanically ventilated patients with sepsis. Methods Sepsis patients who were mechanically ventilated in the intensive care unit (ICU) were included in this randomized controlled study. Patients receiving daily synbiotics (Bifidobacterium breve strain Yakult, Lactobacillus casei strain Shirota, and galactooligosaccharides) initiated within 3 days after admission (the Synbiotics group) were compared with patients who did not receive synbiotics (the No-Synbiotics group). The primary outcome was infectious complications including enteritis, ventilator-associated pneumonia (VAP), and bacteremia within 4 weeks from admission. The secondary outcomes included mortality within 4 weeks, fecal bacterial counts, and organic acid concentration. Enteritis was defined as the acute onset of continuous liquid stools for more than 12 h. Results Seventy-two patients completed this trial; 35 patients received synbiotics and 37 patients did not receive synbiotics. The incidence of enteritis was significantly lower in the Synbiotics than the No-Synbiotics group (6.3% vs. 27.0%; p
Databáze: OpenAIRE
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