Effect of probiotics on prevention of ventilator-associated pneumonia and intestinal function in critically ill patients

Objective To observe the effect of probiotics on prevention of ventilator-associated pneumonia (VAP) and intestinal function in critically ill patients. Methods In this prospective, randomized, controlled study, 155 patients who met the conditions for enrollment were randomly divided into control group and test group.The same treatment was given to all patients, in addition, the patients in test group were given probiotics (Bifidobacterium, Lactobacillus mixture) for three weeks.The incidence of VAP, changes in gut microbiota and incidence of gastrointestinal symptoms were compared between the two groups. Results 120 patients finished the study, including 58 cases in the control group and 62 cases in the test group.The incidence of VAP in the test group was lower than that in the control group (38.7% vs 62.1%, χ2=6.541, P<0.05). The total detection rate of microbial colonization in the oropharynx and stomach of the test group was significantly lower than that of the control group (51.6% vs 89.7%, χ2=20.052, P<0.05). The incidences of increased intra-abdominal pressure, diarrhea, and weakened or disappeared bowel sounds were significantly reduced in the test group (χ2=8.439, 10.849, 13.327, all P<0.05). The proportion of lactobacillus in the intestinal tract of the test group was significantly increased.The time of mechanical ventilation and length of stay in intensive care unit in the test group were also significantly shortened compared with the control group (t=8.051, 6.538, all P<0.05). Conclusions Probiotics preparation can significantly increase the proportion of lactobacillus in the intestinal tract, reduce the incidence of VAP in critically ill patients, reduce the incidence of gastrointestinal symptoms, reduce the time of mechanical ventilation and the length of stay in intensive care unit, then have the value of clinical promotion. Key words: Probiotics; Pneumonia, ventilator-associated; Gut microbiota; Lactobacillus