School of Pharmaceutical Sciences and Medical Technology, Putian University, Putian, Fujian, China.
Division of Urology, Department of Surgery, Chi-Mei Hospital, Chia Li, Taiwan.
Expert Rev Anti Infect Ther. 2022 Sep;20(9):1205-1215. doi: 10.1080/14787210.2022.2089652. Epub 2022 Jun 16.
This study investigated the preventive effects of pro-, pre- and synbiotics on ventilator-associated pneumonia (VAP) among critically ill patients.
The PubMed, Web of Science, Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched for relevant articles written before 19 February 2022. Only randomized controlled trials (RCTs) comparing the clinical efficacy of pro-, pre- and synbiotics with placebos or standard treatments for the prevention of incidental VAP were included.
A total of 15 RCTs were included. Patients receiving pro-, pre- and synbiotics had a lower risk than the control group of contracting VAP (risk ratio [RR], 0.70; 95% CI, 0.57-0.85; = 67%). The duration of mechanical ventilation was significantly shorter in the study group than in the control group (mean difference [MD], -1.61 days; 95% CI, -2.72 to -0.50; = 86%), and the study group had a shorter duration of stay in the intensive care unit than the control group did (MD, -1.72 days; 95% CI, -3.22 to -0.23; = 87%).
Pro-, pre- and synbiotics can prevent VAP and the use of probiotics for patients who are critically ill should be supported.
本研究旨在探讨益生菌、预生元和合生剂对重症患者呼吸机相关性肺炎（VAP）的预防作用。
检索 PubMed、Web of Science、Ovid MEDLINE、Embase、Cochrane 中央对照试验注册库和 ClinicalTrials.gov 数据库，查找截至 2022 年 2 月 19 日前发表的相关文章。仅纳入比较益生菌、预生元和合生剂与安慰剂或标准治疗预防偶发性 VAP 的临床疗效的随机对照试验（RCT）。
共纳入 15 项 RCT。与对照组相比，接受益生菌、预生元和合生剂治疗的患者发生 VAP 的风险更低（风险比 [RR]，0.70；95%置信区间，0.57-0.85； = 67%）。研究组机械通气时间明显短于对照组（平均差 [MD]，-1.61 天；95%置信区间，-2.72 至 -0.50； = 86%），且研究组 ICU 住院时间也短于对照组（MD，-1.72 天；95%置信区间，-3.22 至 -0.23； = 87%）。
益生菌、预生元和合生剂可预防 VAP，应支持对重症患者使用益生菌。
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