AUTHOR=Song Hongzhuan , Hu Wenqing , Zhou Xiujie , Tao Jiaping , Zhang Siyi , Su Xuhong , Wu Wenjun 

TITLE=Clinical Benefits From Administering Probiotics to Mechanical Ventilated Patients in Intensive Care Unit: A PRISMA-Guided Meta-Analysis

JOURNAL=Frontiers in Nutrition

VOLUME=Volume 8 - 2021

YEAR=2022

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2021.798827

DOI=10.3389/fnut.2021.798827

ISSN=2296-861X

ABSTRACT=Background: The use of probiotics has been considered as a new intervention for ventilator-associated pneumonia (VAP) prevention in intensive care unit (ICU). The aim of this meta-analysis was to evaluate the effect of probiotics for mechanical ventilated patients in ICU.
Methods: PubMed, Embase, Scopus, and the Cochrane Library were searched for relevant randomized controlled trials (RCTs) from their respective inception through October 10th, 2021. All studies meeting the inclusion criteria were selected to evaluate the effect of probiotics on patients receiving mechanical ventilation in ICU. 
Results: A total of 15 studies involving 4693 participants met our inclusion criterion and were included in this meta-analysis. The incidence of VAP in the probiotic group was significantly lower (OR 0.58, 95% CI 0.41 to 0.81; P=0.002; I2=71%). However, a publication bias may be present as the test of asymmetry was significant (P=0.007). The probiotic administration was associated with a significant reduction in the duration of mechanical ventilation (MD −1.57, 95% CI −3.12 to −0.03; P=0.05; I2=80%), length of ICU stay (MD −1.87, 95% CI −3.45 to −0.28; P = 0.02; I2=76%), and incidence of bacteria colonization (OR 0.59, 95% CI 0.45 to 0.78; P=0.0001; I2 = 34%;). Moreover, no statistically significant differences were observed regarding incidence of diarrhea (OR 0.90,95% CI 0.65 to 1.25; P=0.54; I2 = 12%) and mortality (OR 0.91, 95% CI 0.80 to 1.05; P=0.19; I2 = 0%) between probiotics group and control group. 
Conclusion: Our meta-analysis shows that probiotics are associated with a reduction in VAP, as well as the duration of mechanical ventilation, ICU length of stay and bacteria colonization, but no significant effects on ICU mortality and occurrence of diarrhea. However, in consideration of the significant heterogeneity and publication bias, our findings need to be further validated.