A Randomised Controlled Trial of Lactobacillus in the Prevention of Ventilator Associated Pneumonia
Journal Title: Journal of Clinical and Diagnostic Research - Year 2019, Vol 13, Issue 8
Abstract
ABSTRACT Introduction: Ventilator Associated Pneumonia (VAP), continues to complicate a significant proportion of critically ill mechanically ventilated patients, resulting in increased morbidity, mortality and hospital costs. Probiotics offer a novel approach to the prevention of VAP. Uncertainty still exists regarding its benefit for the prevention of VAP. Aim: To study the efficacy of probiotic prophylaxis in preventing VAP in the Medical Intensive Care Unit (MICU) of a tertiary hospital in Southern India. Materials and Methods: The study was a prospective, randomised, double-blind, placebo controlled trial that included 146 critically ill, mechanically ventilated adult patients admitted to a 24 bed MICU. Patients in the probiotic group received 2×109 Colony Forming Units (CFU) of Lactobacillus rhamnosus on a twice daily basis (as oral slurry and via nasogastric tube) upto seven days, while those in the placebo arm received identical appearing inert base powder. The primary outcome was incidence of VAP as defined by the clinical criteria of Johansen. Secondary outcomes included duration of mechanical ventilation, MICU stay, hospital stay and mortality. The differences in means and proportions between the two study groups were assessed using independent-t-test and two-sample proportion tests respectively. Results: The incidence of VAP, though lower in the Lactobacillus arm, was not statistically significant- (10% vs. 11%, Lactobacillus vs. placebo). Other outcomes including ICU mortality, median time to VAP, duration of mechanical ventilation, duration of ICU and hospital stay were also not significantly different in the two groups. There were no episodes of Lactobacillus bacteraemia. Conclusion: In critically ill, adult patients admitted to the MICU administration of Lactobacillus rhamnosus did not prevent VAP. ICU mortality, in hospital mortality and median time to VAP were also not influenced by the administration of probiotics.
Authors and Affiliations
Arpudh Michael Anandaraj, Kishore Kumar Pichamuthu, Samuel George Hansdak, Prasanna Samuel, Aparna Irodi, Sniya Valsa, John Victor Peter
Keywords
Related Articles
- EP ID EP640453
- DOI 10.7860/JCDR/2019/42325.13084
- Views 127
- Downloads 0
Twin Reversed Arterial Perfusion: To Treat or Not?
Acardiac twinning or Twin Reverse Arterial Perfusion (TRAP)-sequence is a rare complication of monochorionic twin pregnancy. Whether to start elective or therapeutic treatment in TRAP-sequence is still controversial. In...
Fracture Neck of Femur with Proximal Femoral Nail Antirotation Insitu: A Rare Case
ABSTRACT Hip fractures are common in elderly population due to osteoporosis. Proximal Femur Nail Antirotation (PFNA) system has gained more importance in management of peritrochanteric fractures than conventional Proxima...
Aesthetic Rehabilitation of Class II Malocclusion through Interdisciplinary Approach: A Case Report
Aesthetics has become a respectable concept in dentistry as people are being more concerned of their appearance in today’s world. Malocclusion is one such condition for which patients seek treatment for because of its si...
Surgical Removal of Fractured Endodontic Instrument Extending Beyond the Periapex of Mesiobuccal Root of Maxillary Second Molar through the Maxillary Sinus
Procedural accidents during endodontic treatment often complicate the overall treatment plan of the patient. One of the most frequently encountered procedural accidents is fracture of endodontic instrument. Removal of fr...
Association of Metabolic Obesity and BMI Status with Severity of Angiographic Coronary Artery Disease in Stable Angina Patients
ABSTRACT Introduction: Obesity and metabolic syndrome frequently co-exist and are one of the major health problems around the globe and its prevalence is 25-30%. In India prevalence of metabolic obesity is ≥30%, among fe...