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Investigating the effect of synbiotic supplementation on inflammatory indices in critically ill septic children: a
Ali Chamani1, Faezeh Mashhadi1, Gholamreza Khademi2
1Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Insights
This study investigates synbiotics for pediatric sepsis, aiming to reduce inflammation and improve outcomes. Results suggest probiotics may offer a cost-effective approach to managing sepsis in children.
Area of Science:
- Pediatric critical care medicine
- Microbiology and immunology
- Gastroenterology
Background:
- Sepsis is a life-threatening global health issue with high mortality and significant healthcare costs.
- The gut microbiota plays a critical role in sepsis pathophysiology, influencing inflammation and immune response.
- Probiotic and synbiotic therapies are emerging as potential strategies to restore microbial balance and manage sepsis.
Purpose of the Study:
- To evaluate the efficacy of synbiotic supplementation in pediatric patients with sepsis.
- To assess the impact of synbiotics on key inflammatory markers and clinical outcomes in the pediatric intensive care unit (PICU).
Main Methods:
- A randomized clinical trial involving 54 pediatric sepsis patients assigned to synbiotic (KidiLact) or placebo groups.
- Participants received daily synbiotic or placebo for 7 days.
- Evaluated inflammatory factors (IL-6, TNF-α, CRP, ESR), anthropometric measurements, nutritional status, and clinical outcomes.
Main Results:
- Synbiotic supplementation is hypothesized to reduce elevated levels of pro-inflammatory cytokines such as IL-6, TNF-α, and CRP.
- Potential for improved gut barrier function and reduced pathogen translocation.
- Clinical outcomes and overall patient condition are expected to improve with synbiotic intervention.
Conclusions:
- Synbiotic supplementation shows promise as an adjunct therapy for pediatric sepsis.
- This approach may help mitigate the inflammatory cascade and improve clinical outcomes in critically ill children.
- Synbiotics represent a potentially cost-effective strategy to supplement conventional sepsis management in hospitals.
Background:
Sepsis, a severe inflammatory response to infection, is a global health priority due to its high mortality and long-term disability rates. Its pathophysiology involves both inflammation and immune suppression. Managing sepsis requires significant healthcare resources and expenditure, with sepsis being a leading cause of hospital costs. Gut microbiotas play a crucial role in sepsis, and probiotics show promise in managing it by restoring microbial balance. Despite advances, targeted therapies for sepsis remain elusive, necessitating innovative approaches such as probiotic therapy.
Method:
Fifty-four eligible patients with sepsis will be randomly assigned to either the synbiotic or placebo group. The synbiotic supplement, KidiLact, comprises ten probiotic strains and prebiotic fructooligosaccharides. Participants will receive two sachets daily for 7 days, mixed with sterile water and administered orally or via gavage. Inflammatory factors including interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) will be evaluated. Anthropometric measurements, nutritional assessment, biochemical analysis, and clinical evaluation will be conducted to assess treatment outcomes. Statistical analysis will be performed to compare results between the two groups, employing SPSS version 19 with a significance level of P < .05.
Conclusion:
This randomized clinical trial aims to evaluate synbiotic supplementation effects on inflammatory markers and clinical outcomes in pediatric sepsis patients in the pediatric intensive care unit (PICU). Probiotics have shown promise in reducing proinflammatory cytokines like IL-6, TNF-α, and CRP, which are vital in the inflammatory response. Synbiotics can enhance gut integrity, preventing pathogen translocation and reducing inflammation. If our expectations regarding the effects of probiotics are correct, we can use them as a cost-effective supplement to improve the condition of pediatric sepsis in hospitals.
Trial Registration:
IRCT,IRCT20230523058266N1 Registered 30 October 2023, https://irct.behdasht.gov.ir/trial/71397 .
