益生菌或共生菌在重症患者中的有效性:系统性审查和元分析
Jiaqi Lou1, Shengyong Cui1, Neng Huang1
1Burn Department, Ningbo No. 2 Hospital, Ningbo, Zhejiang Province, China.
Clinical nutrition ESPEN
|January 14, 2024
概括
益生菌和共生菌补充剂通过减少呼吸机相关的肺炎和败血症,显著有利于重症患者. 这些干预措施还减少了机械通风的持续时间和住院/ICU的时间,尽管它们不会影响其他感染或死亡率.
科学领域:
- 关键护理医学 关键护理医学
- 微生物学 微生物学
- 营养科学 营养科学
背景情况:
- 危急病患者容易感染呼吸器相关肺炎 (VAP) 和败血症等感染.
- 肠道微生物组在关键疾病的结果中起着至关重要的作用.
- 益生菌和共生菌提供了肠道微生物群的潜在调节.
研究的目的:
- 系统地审查和分析益生菌和共生菌补充剂在重症患者的效果.
- 评估对关键临床结果的影响,包括VAP,败血症和死亡率.
主要方法:
- 对33项涉及4065名接受益生菌/共生菌治疗的患者和3821名对照患者的研究进行了系统审查和元分析.
- 数据使用相对风险 (RR) 和标准化平均差异 (SMD) 以95%的置信区间进行了聚合.
- 主要结局:VAP的发生率. 二次结局:腹,困难菌感染 (CDI),败血症,医院获得的肺炎,机械通风持续时间,ICU死亡率,ICU停留时间,住院死亡率和住院时间.
主要成果:
- 益生菌/共生菌补充剂显著降低了VAP (RR=0.80) 和败血症 (RR=0.97) 的发生率.
- 治疗组显示,机械呼吸持续时间 (SMD=-0.47),ICU死亡率 (RR=0.95),ICU停留时间 (SMD=-0.29) 和住院时间 (SMD=-0.33) 显著增加.
- 对于腹,CDI,医院获得的肺炎发病率或住院死亡率没有发现显著差异.
结论:
- 益生菌和共生菌补充剂对重症患者有显著的益处.
- 这些补充剂有效地减少了VAP和败血症的发生率,并缩短了机械通风和住院/ICU的时间.
- 对腹,CDI和整体死亡率等其他结果的影响很小.
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