Related Experiment Video
Updated: Apr 17, 2026
Probiotic Studies in Neonatal Mice Using Gavage
Published on: January 27, 2019
Probiotic prophylaxis to prevent ventilator associated pneumonia (VAP) in children on mechanical ventilation: an
Balasubramaniam Banupriya1, Niranjan Biswal, Rangan Srinivasaraghavan
1Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605006, India.
Insights
Prophylactic probiotics significantly reduced ventilator-associated pneumonia (VAP) in critically ill children. This safe intervention also shortened intensive care unit (ICU) and hospital stays.
Area of Science:
- Critical Care Medicine
- Pediatric Intensive Care
- Infectious Diseases
Background:
- Ventilator-associated pneumonia (VAP) is a common and serious nosocomial infection in pediatric intensive care units (PICUs).
- VAP is associated with increased mortality and prolonged hospital stays.
- Limited studies exist on VAP prevention using probiotics in pediatric populations.
Purpose of the Study:
- To evaluate the efficacy and safety of prophylactic probiotic administration in preventing VAP in critically ill children.
- To assess the impact of probiotics on VAP incidence, duration of hospital stay, and mortality.
Main Methods:
- An open-label randomized controlled trial involving 150 children (≤12 years) requiring ventilation for >48 hours.
- Patients were randomized into probiotic intervention and control groups.
- Probiotic group received probiotics twice daily until ICU discharge or 7 days; control group received no placebo. VAP incidence and clinical outcomes were monitored.
Main Results:
- The incidence of VAP was significantly lower in the probiotic group (17.1%) compared to the control group (48.6%) (p < 0.001).
- Prophylactic probiotics reduced VAP by 77% and decreased ICU and hospital stays by 2.1 and 3.3 days, respectively.
- No adverse complications were reported with probiotic administration.
Conclusions:
- Prophylactic probiotic administration is a safe and effective strategy for reducing VAP incidence in critically ill children.
- This intervention shows promise in high-VAP-rate settings and contributes to shorter hospitalizations.
Purpose:
Ventilator associated pneumonia (VAP) is one of the most common nosocomial infections in the pediatric intensive care unit (PICU). It is associated with increased mortality and prolonged hospital stay. Several preventive strategies have been introduced to reduce VAP. One novel intervention is prophylactic administration of probiotics. Studies on the effect of probiotics on VAP in pediatric populations are lacking.
Methods:
This was an open-label randomized controlled trial. A total of 150 children no older than 12 years admitted to the PICU were recruited from November 2011 to July 2013. Children who were likely to require ventilation for more than 48 h were eligible for inclusion in the study. Patients were randomized into two groups after stratification based on age groups. Children in the intervention group received probiotic preparation twice a day beginning from the day of ICU admission till 7 days or discharge from ICU, whichever was earlier. The control group did not receive any placebo. Children were examined daily for evidence of VAP and were followed up till discharge from hospital. Incidence of VAP, duration of hospital stay, and mortality were compared.
Results:
Children who received prophylactic probiotics had a lower incidence of VAP compared to the control group (17.1 % in the probiotics group vs 48.6 % in the control group, p < 0.001; 22 per 1,000 ventilated days vs 39 per 1,000 ventilated days, p = 0.02). On multiple logistic regression analysis, use of prophylactic probiotics decreased the incidence of VAP by 77 % and reduced the duration of ICU and hospital stays by an average of 2.1 and 3.3 days, respectively, after adjusting for the other confounders. No complications due to administration of probiotics were observed in the study.
Conclusion:
Prophylactic probiotics administration resulted in reduction of the incidence of VAP in critically ill children in a setting where baseline VAP rates are high. The intervention was found to be safe.
More Related Videos
Related Concept Videos
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:22Probiotics
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:23Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation...
01:23Mechanical Ventilation II: Invasive Ventilation
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
01:25Transmission-based Precautions II: Airborne and Protective Environment
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...