Synbiotics for prevention of ventilator-associated pneumonia: a probiotics strain-specific network meta-analysis

被引：17
作者：
Fan, Qiong-Li [1 ]
Yu, Xiu-Mei [1 ]
Liu, Quan-Xing [2 ]
Yang, Wang [1 ]
Chang, Qin [1 ]
Zhang, Yu-Ping [1 ]
机构：
[1] Army Med Univ, Xinqiao Hosp, Dept Pediat, Chongqing, Peoples R China
[2] Army Med Univ, Xinqiao Hosp, Dept Thorac Surg, Chongqing, Peoples R China
来源：
JOURNAL OF INTERNATIONAL MEDICAL RESEARCH | 2019年 / 47卷 / 11期
关键词：
Network meta-analysis; probiotics; randomized controlled trial; ventilator-associated pneumonia; systematic review; mortality; CRITICALLY-ILL PATIENTS; DIGESTIVE-TRACT; SELECTIVE DECONTAMINATION; PROPHYLAXIS; MANAGEMENT; QUALITY; TRIALS;
D O I：
10.1177/0300060519876753
中图分类号：
R-3 [医学研究方法]; R3 [基础医学];
学科分类号：
1001 ;
摘要：
Objective Probiotics may be efficacious in preventing ventilator-associated pneumonia (VAP). The aim of this network meta-analysis (NMA) was to clarify the efficacy of different types of probiotics for preventing VAP. Methods This systematic review and NMA was conducted according to the updated preferred reporting items for systematic review and meta-analysis. A systematic literature search of public databases from inception to 17 June 2018 was performed. Results NMA showed that "Bifidobacterium longum + Lactobacillus bulgaricus + Streptococcus thermophiles" was more efficacious than "Ergyphilus" in preventing VAP (odds ratio: 0.15, 95% confidence interval: 0.03-0.94). According to pairwise meta-analysis, "B. longum + L. bulgaricus + S. thermophiles" and "Lactobacillus rhamnosus" were superior to placebo in preventing VAP. Treatment rank based on surface under the cumulative ranking curves revealed that the most efficacious treatment for preventing VAP was "B. longum + L. bulgaricus + S. thermophiles" (66%). In terms of reducing hospital mortality and ICU mortality, the most efficacious treatment was Synbiotic 2000FORTE (34% and 46%, respectively). Conclusions Based on efficacy ranking, "B. longum + L. bulgaricus + S. thermophiles" should be the first choice for prevention of VAP, while Synbiotic 2000FORTE has the potential to reduce in-hospital mortality and ICU mortality.
引用
收藏
页码：5349 / 5374
页数：26
相关论文
共 38 条
[1]   Probiotic prophylaxis to prevent ventilator associated pneumonia (VAP) in children on mechanical ventilation: an open-label randomized controlled trial [J].
Banupriya, Balasubramaniam ;
Biswal, Niranjan ;
Srinivasaraghavan, Rangan ;
Narayanan, Parameswaran ;
Mandal, Jharna .
INTENSIVE CARE MEDICINE, 2015, 41 (04) :677-685
[2]   Probiotics in the critically ill patient: a double blind, randomized, placebo-controlled trial [J].
Barraud, Damien ;
Blard, Claire ;
Hein, Francois ;
Marcon, Olivier ;
Cravoisy, Aurelie ;
Nace, Lionel ;
Alla, Francois ;
Bollaert, Pierre-Edouard ;
Gibot, Sebastien .
INTENSIVE CARE MEDICINE, 2010, 36 (09) :1540-1547
[3]   Quantitative Cultures of Bronchoscopically Obtained Specimens Should Be Performed for Optimal Management of Ventilator-Associated Pneumonia [J].
Baselski, Vickie ;
Klutts, J. Stacey .
JOURNAL OF CLINICAL MICROBIOLOGY, 2013, 51 (03) :740-744
[4]   Graphical Tools for Network Meta-Analysis in STATA [J].
Chaimani, Anna ;
Higgins, Julian P. T. ;
Mavridis, Dimitris ;
Spyridonos, Panagiota ;
Salanti, Georgia .
PLOS ONE, 2013, 8 (10)
[5]   Preventing ventilator-associated pneumonia in adults - Sowing seeds of change [J].
Craven, Donald E. .
CHEST, 2006, 130 (01) :251-260
[6]   Effects of selective decontamination of digestive tract on mortality and acquisition of resistant bacteria in intensive care: a randomised controlled trial [J].
de Jonge, E ;
Schultz, MJ ;
Spanjaard, L ;
Bossuyt, PMM ;
Vroom, MB ;
Dankert, J ;
Kesecioglu, J .
LANCET, 2003, 362 (9389) :1011-1016
[7]   Decontamination of the Digestive Tract and Oropharynx in ICU Patients [J].
de Smet, A. M. G. A. ;
Kluytmans, J. A. J. W. ;
Cooper, B. S. ;
Mascini, E. M. ;
Benus, R. F. J. ;
van der Werf, T. S. ;
van der Hoeven, J. G. ;
Pickkers, P. ;
Bogaers-Hofman, D. ;
van der Meer, N. J. M. ;
Bernards, A. T. ;
Kuijper, E. J. ;
Joore, J. C. A. ;
Hall, M. A. Leverstein-van ;
Bindels, A. J. G. H. ;
Jansz, A. R. ;
Wesselink, R. M. J. ;
de Jongh, B. M. ;
Dennesen, P. J. W. ;
van Asselt, G. J. ;
Velde, L. F. te ;
Frenay, I. H. M. E. ;
Kaasjager, K. ;
Bosch, F. H. ;
van Iterson, M. ;
Thijsen, S. F. T. ;
Kluge, G. H. ;
Pauw, W. ;
de Vries, J. W. ;
Kaan, J. A. ;
Arends, J. P. ;
Aarts, L. P. H. J. ;
Sturm, P. D. J. ;
Harinck, H. I. J. ;
Voss, A. ;
Uijtendaal, E. V. ;
Blok, H. E. M. ;
Groen, E. S. Thieme ;
Pouw, M. E. ;
Kalkman, C. J. ;
Bonten, M. J. M. .
NEW ENGLAND JOURNAL OF MEDICINE, 2009, 360 (01) :20-31
[8]   Bacterial resistance and overgrowth due to selective decontamination of the digestive tract [J].
Ebner, W ;
Kropec-Hübner, A ;
Daschner, FD .
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 2000, 19 (04) :243-247
[9]   GetReal in network meta-analysis: a review of the methodology [J].
Efthimiou, Orestis ;
Debray, Thomas P. A. ;
van Valkenhoef, Gert ;
Trelle, Sven ;
Panayidou, Klea ;
Moons, Karel G. M. ;
Reitsma, Johannes B. ;
Shang, Aijing ;
Salanti, Georgia .
RESEARCH SYNTHESIS METHODS, 2016, 7 (03) :236-263
[10]   Oral probiotic and prevention of Pseudomonas aeruginosa infections:: a randomized, double-blind, placebo-controlled pilot study in intensive care unit patients [J].
Forestier, Christiane ;
Guelon, Dominique ;
Cluytens, Valerie ;
Gillart, Thierry ;
Sirot, Jacques ;
De Champs, Christophe .
CRITICAL CARE, 2008, 12 (03)
1234