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Effect of probiotic administration in the therapy of pediatric thermal burn
M H El-Ghazely1, W H Mahmoud1, M A Atia1
1Plastic, Reconstructive Surgery and Burns Department, Tanta Faculty of Medicine, Tanta, Egypt.
Insights
Oral probiotics improved outcomes for pediatric burn patients, reducing diarrhea, grafting needs, and hospital stays. Further research is needed to clarify effects on infection and mortality.
Area of Science:
- Pediatric critical care
- Gastroenterology
- Immunology
Background:
- Oral probiotics are explored for various health conditions.
- Pediatric burn patients face significant clinical challenges.
Purpose of the Study:
- To assess the impact of oral probiotic supplementation on pediatric post-burn patient outcomes.
- To evaluate clinical and laboratory markers in burn patients receiving probiotics versus placebo.
Main Methods:
- Prospective, double-blind, randomized controlled trial involving 40 pediatric burn patients.
- Patients were divided into probiotic and placebo groups.
- Clinical outcomes (GIT tolerance, infection, grafting, hospital stay, mortality) and laboratory markers (CRP, albumin, IgA, lymphocyte count) were monitored.
Main Results:
- The probiotic group showed significantly lower frequencies of diarrhea (p=0.038), need for grafting (p=0.028), and shorter hospital stays (p=0.044).
- A trend towards reduced infection incidence was observed in the probiotic group (p=0.113).
- No significant differences in mortality or baseline characteristics were noted.
Conclusions:
- Oral probiotic supplementation may improve overall outcomes in pediatric burn patients, particularly regarding gastrointestinal tolerance and length of hospital stay.
- The study suggests potential benefits in reducing the need for surgical grafting.
- Further investigation is required to definitively establish the role of probiotics in managing infectious morbidity and mortality in this patient population.
Abstract:
Oral probiotic administration has been advocated for treatment and prevention of a diverse range of disorders. This study was undertaken to evaluate the effect of probiotic supplementation on outcome of pediatric post-burn patients. Forty thermally-injured pediatric patients with total body surface burns between 20-50% and depth between 5-10% were randomized in a prospective, double-blind, controlled clinical trial into two even groups: probiotic group (n=20), who received probiotic preparations, and placebo control group (n=20). Clinical outcomes, including GIT tolerance, incidence of infection, need for grafting, length of hospital stay and mortality were recorded. Laboratory measurements of serum CRP, serum albumin, serum IgA and total lymphocyte count were done upon admission and on days 4, 7 and 14. There were no significant differences between the groups regarding age (3.67 ± 0.67 vs. 3.56 ± 0.73), sex, %BSA (34.5 ± 1.96 vs. 33.9 ± 1.82) and %deep burns (6.95 ± 0.34 vs. 7.25 ± 0.39). Frequency of diarrhea (3 vs. 9), need for grafting (2 vs. 8) and length of hospital stay (17.25 ± 0.5 days vs. 21.9 ± 2.2 days) were significantly lower in the probiotic group (p=0.038, p=0.028 and p=0.044, respectively). A trend towards a decrease in incidence of infections (7 vs. 12) was noted in the probiotic group (p=0.113). There was no mortality in our series. There was improvement in the patients' overall outcome related to wound healing and length of hospital stay following the use of probiotics. However, their effects on infectious morbidity and mortality remain unclear and require further investigation.
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