Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

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doi: 10.17219/acem/157407

Publication type: meta-analysis

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

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Wang B, Xie J, Teng Y. A meta-analysis of the effects of probiotics on various parameters in critically ill ventilated individuals [published online as ahead of print on March 16, 2023]. Adv Clin Exp Med. 2023. doi:10.17219/acem/157407

A meta-analysis of the effects of probiotics on various parameters in critically ill ventilated individuals

Bo Wang1,A, Ji Xie2,B, Yao Teng3,D,F

1 Department of Intensive Care Medicine, No. 903 Hospital of PLA Joint Logistic Support Force, Hangzhou, China

2 Department of Emergency Medicine, Jinling Hospital, Medical School of Nanjing University, China

3 Department of Emergency Medicine, The Fourth Affiliated Hospital of Nanjing Medical University, China

Abstract

Background. According to reports, ventilator-associated pneumonia affects critically ill patients more frequently than any other nosocomial infection. Probiotic usage as a prophylactic intervention has shown promising results in numerous studies.
Objectives. We performed a meta-analysis to evaluate the effect of probiotics on different parameters in critically ill ventilated subjects.
Material and Methods. A systematic literature search up to June 2022 was performed and 5893 critically ill ventilated subjects at the baseline of the studies were identified; 2912 of them were using the probiotics, and there were 2981 controls. Odds ratio (OR) and mean difference (MD) with 95% confidence interval (95% CI) were calculated to assess the effect of probiotics on different parameters in critically ill ventilated subjects using the dichotomous and contentious methods with a random or fixed effects model.
Results. The probiotics caused a significantly lower incidence of ventilator-associated pneumonia (OR = 0.52; 95% CI: 0.40–0.68, p < 0.001), shorter duration of mechanical ventilation (MD = −2.22; 95% CI: −3.33–−1.11, p < 0.001), shorter intensive care unit (ICU) stay (MD = −2.09; 95% CI: −3.41–−0.77, p = 0.002), shorter hospital stay (MD = −2.36; 95% CI: −4.54–−0.19, p = 0.03), and lower oropharyngeal colonization (OR = 0.59; 95% CI: 0.36–0.96, p = 0.03) in critically ill ventilated subjects compared with controls. However, probiotic use had no significant difference in terms of diarrhea incidence (OR = 0.74; 95% CI: 0.52–1.07, p = 0.11) and in-hospital mortality (OR = 0.90; 95% CI: 0.79–1.03, p = 0.14) in critically ill ventilated subjects compared with controls.
Conclusion. Probiotics caused a significantly lower ventilator-associated pneumonia incidence, shorter duration of mechanical ventilation, shorter ICU and hospital stay, and lower oropharyngeal colonization. However, there was no significant difference in terms of diarrhea incidence and in-hospital mortality in subjects who used probiotics compared with controls. The low sample size of 9 out of 27 researches and the small number of studies in several comparisons requires attention when analyzing the results.

Key words

probiotic, ventilator-associated pneumonia, length of hospital stay, critically ill ventilated adult, oropharyngeal colonization

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