Clinical review: Probiotics in critical care

Abstract

Patients in ICUs represent a relatively small subgroup of hospitalised patients, but they account for approximately 25% of all hospital infections. Approximately 30% of ICU patients suffer from infection as a complication of critical illness, which increases the length of ICU stay, morbidity, mortality and cost. Gram-negative bacteria are the predominant cause of ICU-related infections and with the rise in multidrug-resistant strains we should focus our attention on nonantibiotic strategies in the prevention and treatment of nosocomial infections. Probiotics have been proposed as one option in this quest; however, mechanisms of action in the critically ill population require further investigation. Some of the beneficial effects appear to be associated with improvement in gastrointestinal barrier function, restoration of normal intestinal permeability and motility, modification of the balance of intestinal microbiota and immunomodulation. However, the information we have to date on the use of probiotics in the critical care setting is difficult to interpret due to small sample sizes, differences in ICU populations, the variety of probiotic combinations studied and differences in administration techniques. In this review we shall examine the use of probiotics in the critical care setting, look at some of the proposed mechanisms of action and discuss their potential benefits and drawbacks.

Probiotic Supplementation and Late-Onset Sepsis in Preterm Infants: A Meta-analysis

“…22 Probiotics are defined as live microorganisms that when administered in adequate amounts may confer health benefits on people with specific illnesses. 23 Animal research and in vitro studies 24 have shown that probiotics improve gut barrier function, 25,26 inhibit gut colonization with pathogenic bacteria, 27 improve colonization with healthy commensals, 28,29 protect from enteropathogenic infection through production of acetate, 30 enhance innate immunity, 31 and increase maturation of the enteric nervous system, 32 all of which have the potential to decrease the risk of LOS in preterm infants. However, the recent Cochrane Review 33 (2014) 34 (2015) also reported similar results on LOS (RR, 0.919; 95% CI, 0.823-1.027; P = .137; 17 randomized controlled trials [RCTs], N = 5215).…”

Probiotik Meningkatkan Konsentrasi Hemoglobin Pada Tikus Putih Yang Diinduksi Lipopolisakarida Escherichia Coli

“…7,8 Kondisi inflamasi yang meluas akibat infeksi bakteri terbukti meningkatkan lama perawatan (length of stay), biaya perawatan, morbiditas, dan mortalitas pasien. 9 Upaya pencegahan dibutuhkan agar kondisi infeksi tidak meluas dan berkembang menjadi sepsis, serta menjaga agar parameter hematologi pasien tetap normal, yaitu dengan meningkatkan sistem kekebalan tubuh atau imunitas pasien. Salah satu upaya meningkatkan imunitas adalah dengan pemberian bakteri asam laktat (BAL) yang di isolasi menjadi probiotik.…”

Influence Violations Formation of Intestinal Flora, Intestinal Barrier Function in Newborns of Infectious and Inflammatory Diseases and the Importance of Probiotics in Their Prevention

“…у 2010 р. [9] та результатами інших дослідників [3,7,8], внутрішнє застосування пре-і пробіотиків вважається обгрунтованим (табл.1; 2; 3). Рекомендації з інших клінічних і доклінічних питань із застосування пробіотиків Рекомендації 1.Початкова доза для ДДМТ: 1,5 × 109 КУО / добу до досягнення ентерального харчування 50-60 мл / кг /добу.…”