当前位置: X-MOL 学术ICMx › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Manipulation of the microbiome in critical illness—probiotics as a preventive measure against ventilator-associated pneumonia
Intensive Care Medicine Experimental Pub Date : 2019-07-01 , DOI: 10.1186/s40635-019-0238-1
Marel C E van Ruissen 1 , Lieuwe D Bos 2, 3 , Robert P Dickson 4 , Arjen M Dondorp 3, 5 , Constance Schultsz 1 , Marcus J Schultz 3, 5, 6
Affiliation  

To describe the possible modes of action of probiotics and provide a systematic review of the current evidence on the efficacy of probiotics to prevent ventilator-associated pneumonia (VAP) in critically ill patients. We conducted an unrestricted search of the English language medical literature. For each individual study, the relative risk of VAP was calculated using the reported primary outcome data. The search identified a total of 72 articles. Eight articles enrolling a total of 1229 patients fulfilled the inclusion and exclusion criteria. In four trials, the investigators were blinded for the intervention, and two trials used an intention-to-treat analysis. Loss to follow-up with regard to the primary endpoint ranged from 0 to 14% in the intervention groups and from 0 to 16% in the control groups. The incidence of VAP expressed as the percentage of studied patients was reported in seven trials. The incidence of VAP ranged from 4 to 36% in the intervention groups and from 13 to 50% in the control groups. The relative risk for VAP ranged between 0.30 and 1.41. Three trials showed a significant difference in favor of probiotic therapy between the intervention and the control groups. The incidence of VAP tended to be lower in patients treated with probiotics in most trials identified by the systematic search. Due to the heterogeneity of the studies and the low quality of evidence, it remains difficult to draw firm conclusions. The efficacy of preventive probiotics should be studied in more detail in future trials. Application of probiotics for the prevention of VAP seems to be safe with only few side effects reported in the selected trials.

中文翻译:

危重病微生物组的调控——益生菌作为呼吸机相关性肺炎的预防措施

描述益生菌可能的作用方式,并对益生菌预防重症患者呼吸机相关性肺炎 (VAP) 的功效的当前证据进行系统评价。我们对英语医学文献进行了不受限制的搜索。对于每项单独的研究,使用报告的主要结果数据计算 VAP 的相对风险。搜索共确定了 72 篇文章。8 篇文章共纳入 1229 名患者,符合纳入和排除标准。在四项试验中,研究人员对干预不知情,两项试验使用了意向治疗分析。主要终点的失访率在干预组中为 0% 至 14%,在对照组中为 0% 至 16%。七项试验报告了 VAP 的发生率,以研究患者的百分比表示。VAP 的发生率在干预组中为 4% 至 36%,在对照组中为 13% 至 50%。VAP 的相对风险介于 0.30 和 1.41 之间。三项试验显示干预组和对照组之间在益生菌治疗方面存在显着差异。在系统搜索确定的大多数试验中,使用益生菌治疗的患者的 VAP 发生率往往较低。由于研究的异质性和证据的低质量,仍然难以得出确切的结论。应在未来的试验中更详细地研究预防性益生菌的功效。应用益生菌预防 VAP 似乎是安全的,在选定的试验中报告的副作用很少。
更新日期:2019-07-01
down
wechat
bug