Naseri Amirreza, Seyedi-Sahebari Sepideh, Mahmoodpoor Ata, Sanaie Sarvin
Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Research Center for Evidence-based-Medicine, Iranian EBM Center: A Joanna Briggs Institute (JBI) Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Anesthesiology and Critical Care, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Indian J Crit Care Med. 2022 Mar;26(3):339-360. doi: 10.5005/jp-journals-10071-24129.
Probiotics are live microorganisms which when administered in adequate amounts confer a health benefit on the host. Because of the wide usage of antibiotics, acute changes in diet, and the stress of illness, critically ill patients' homeostasis of the gut microbiome can be disrupted during intensive care unit (ICU) confinement; probiotics are suggested as a beneficial intervention in critically ill patients. We tried to give an overview of the effects of probiotic supplements in critically ill patients based on published systematic reviews (SRs) and meta-analyses (MAs).
A systematic search was performed in four databases as well as hand searching.
The results were independently screened in two title/abstracts and full-text stages.
Any reported outcomes in each study were extracted, using a data extraction table.
A wide range of outcomes of using probiotic supplements in critically ill patients have been reported in 20 included studies. Based on the current knowledge, we can say that probiotics may reduce the rate of ventilator-associated pneumonia, nosocomial pneumonia, the overall infection rate, duration of mechanical ventilation, and antibiotic use in critically ill patients, but there is not a significant association between using the probiotics and mortality, length of hospitalization, and incidence of diarrhea.
Despite the various beneficial effects of probiotics in critically ill patients, there is not yet much evidence supporting the routine use of these supplements and further well-designed multicenter trials are needed to provide "evidence-based" recommendations.
Naseri A, Seyedi-Sahebari S, Mahmoodpoor A, Sanaie S. Probiotics in Critically Ill Patients: An Umbrella Review. Indian J Crit Care Med 2022;26(3):339-360.
益生菌是一类活的微生物，当给予足够数量时能给宿主带来健康益处。由于抗生素的广泛使用、饮食的急剧变化以及疾病的压力，重症患者在重症监护病房（ICU）住院期间肠道微生物群的稳态可能会被破坏；益生菌被认为是对重症患者有益的干预措施。我们试图基于已发表的系统评价（SRs）和荟萃分析（MAs），对益生菌补充剂在重症患者中的作用进行概述。
在四个数据库中进行了系统检索，并进行了手工检索。
结果在标题/摘要和全文两个阶段进行独立筛选。
使用数据提取表提取每项研究中报告的任何结果。
20项纳入研究报告了在重症患者中使用益生菌补充剂的广泛结果。基于目前的知识，我们可以说益生菌可能会降低重症患者呼吸机相关性肺炎、医院获得性肺炎的发生率、总体感染率、机械通气时间和抗生素使用，但使用益生菌与死亡率、住院时间和腹泻发生率之间没有显著关联。
尽管益生菌对重症患者有多种有益作用，但目前尚无充分证据支持常规使用这些补充剂，需要进一步开展设计良好的多中心试验以提供“基于证据”的建议。
Naseri A, Seyedi-Sahebari S, Mahmoodpoor A, Sanaie S. Probiotics in Critically Ill Patients: An Umbrella Review. Indian J Crit Care Med 2022;26(3):339-360.
