Impact of synbiotics (Synbiotic 2000 Forte) on monocyte function in long-term ICU patients

Introduction

The impact of synbiotics on enteral feeding tolerance and immune function has been studied. We designed a protocol monitoring impact of synbiotics on these variables in long-term ICU patients.

Patients and methods

Patients estimated on D1 (D0 = admission) to stay in the ICU >3 days were randomized (according to age, sex, SOFA score and diagnosis group) to postpyloric placebo (tea) or treatment (Synbiotic) groups. Monocyte function was monitored on D1 and then at 5-day intervals; enteral nutrition (EN) was given according to the standard ICU protocol.

Preliminary analysis of early development (D1–D5–D10) of CD14⁺HLADR⁺ expression and tolerance of enteral feeding is reported. Data are presented as the median (Q25; Q75). Kruskal-Wallis ANOVA and Wilcoxon tests were used when appropriate, P < 0.05 considered significant.

Results

Twelve patients (10 male, two female; age 54 [39; 63] years) were randomized and 11 were eligible for analysis (Synbiotic n = 6, placebo n = 5). Ten patients survived the ICU stay (S), and one did not (NS). The APACHE II score on admission was 22 (21; 26.5). The course of CD14⁺HLADR⁺ did not differ in the Synbiotic/placebo groups (Table 1). In two placebo and no Synbiotic patients a significant drop of 15% was measured. The amount of EN (10 days) is higher in the Synbiotic than the placebo group (6930 ml [6490; 7292] vs 5010 ml [4747; 5237], P < 0.05), as was the frequency of stool (9 [4; 14] vs 1 [0; 4], P = 0.13).

Table 1 (abstract P212)

Conclusion

Preliminary data do not show a major impact of synbiotics on monocyte function. Tolerance of EN seems to be better in the synbiotics group.