Prebiotic, probiotic and synbiotic usage and gastrointestinal and trachea colonization in mechanically ventilated patients

Introduction

Sepsis, and its complications, is the main causes of death in the ICU. New preventive measures for nosocomial infections have been researched as an alternative to antibiotic administration, such as probiotic usage.

Methods

This clinical, randomized trial evaluated 49 patients who were admitted to the ICU of Hospital Universitário Clementino Fraga Filho and were mechanically ventilated. The patients were randomized into one of four groups: control (n = 16), prebiotic (n = 10), probiotic (n = 12) or synbiotic (n = 11). Enteral nutrition, fibers, and lactobacillus were administered for 14 days. Colonization of the gastrointestinal tract, trachea, and the incidence of nosocomial infections, particularly ventilation-associated pneumonia, were measured. Other outcomes measured included duration of mechanical ventilation, length of stay in the ICU, duration of hospitalization, mortality rates, and development of organ dysfunction.

Results

The groups were matched at admission. There was no difference between the groups in relation to the incidence of ventilator-associated pneumonia or the incidence of nosocomial infection. There was a nonsignificant increase in the proportion of enterobacteria in the trachea at the seventh day in the prebiotic and probiotic groups compared with the control group. There was a nonsignificant decrease in the number of bacteria found in the stomach in the prebiotic, probiotic and synbiotic groups at day 7. No significant difference with regard to the remaining measured parameters could be found.

Conclusion

Prebiotic, probiotic and synbiotic usage had no effect in the colonization of the gastrointestinal tract and trachea of mechanically ventilated patients.