Abstract:ObjectiveProbiotics 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.MethodsThis 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.ResultsNMA showed that “Bifidobacterium longum + Lactobacil… Show more
“…The databases and hand searches identified 1925 unique title or abstracts. Full texts of 77 studies were reviewed, and 48 studies were included in scoping review, including 17 systematic reviews, [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] 26 randomized controlled trials, and 5 nonrandomized controlled trials (including both nonrandomized controlled trials and observational studies) [65][66][67][68][69] (Figure 3). targeted adults who were critically ill and mechanically ventilated, and 5 articles 29,54,56,57,65 included individuals with various conditions, such as respiratory tract infections or influenza ( Figure 4).…”
Section: Resultsmentioning
confidence: 99%
“…The databases and hand searches identified 1925 unique title or abstracts. Full texts of 77 studies were reviewed, and 48 studies were included in scoping review, including 17 systematic reviews, 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 26 randomized controlled trials, 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 and 5 nonrandomized controlled trials (including both nonrandomized controlled trials and observational studies) 65 , 66 , 67 , 68 , 69 ( Figure 3 ). Figure 3 Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram for scoping review of literature examining the effects of probiotics on coronavirus disease 2019–related outcomes.…”
Section: Resultsmentioning
confidence: 99%
“…Of the 48 included articles, 23 articles 23 , 24 , 25 , 26 , 30 , 31 , 36 , 37 , 40 , 43 , 44 , 45 , 46 , 47 , 49 , 50 , 52 , 53 , 55 , 58 , 60 , 64 , 69 focused on participants who were critically ill but not mechanically ventilated, 20 articles 22 , 27 , 28 , 32 , 33 , 34 , 35 , 38 , 39 , 41 , 42 , 51 , 59 , 61 , 62 , 63 , 66 , 67 , 68 , 69 targeted adults who were critically ill and mechanically ventilated, and 5 articles 29 , 54 , 56 , 57 , 65 included individuals with various conditions, such as respiratory tract infections or influenza ( Figure 4 ). All articles focused on the adult population, which may include older adults, but none of them focused exclusively on older populations.…”
Section: Resultsmentioning
confidence: 99%
“…Seventeen systematic reviews and guidelines were included in this scoping review. 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 The authors’ conclusions and certainty of evidence for systematic reviews published from 2010 to 2020 are shown in Figure 7 . In these systematic reviews, authors’ conclusions are heterogeneous, though there were no systematic reviews describing high-quality evidence examining the effect of probiotics in the populations of interest.…”
Section: Resultsmentioning
confidence: 99%
“…In these systematic reviews, authors’ conclusions are heterogeneous, though there were no systematic reviews describing high-quality evidence examining the effect of probiotics in the populations of interest. Most of the systematic reviews describe that probiotics decreased incidence of ventilator-associated pneumonia, 26 , 27 , 28 , 34 , 35 , 36 although other systematic reviews that specifically focused on ventilator-associated pneumonia incidence concluded no beneficial effect from probiotics. 22 , 29 , 32 Several authors describe that intervention heterogeneity 22 , 25 , 26 , 29 , 32 , 34 , 36 or risk of bias 24 , 25 , 26 , 29 , 34 , 36 were a concern.…”
Probiotics have been suggested as a potential intervention for improving outcomes, particularly ventilatory-associated pneumonia, in patients infected with coronavirus disease 2019 (COVID-19). However, with the rapid development of the COVID-19 pandemic, there is little direct evidence available in infected patients. The objective of this scoping review is to examine the availability and nature of literature describing the effect of probiotics in adults with conditions or infections similar to COVID-19 infection on related health outcomes. MEDLINE, Cumulative Index to Nursing & Allied Health Literature, and Cochrane Databases were searched for studies published from 1999 to May 1, 2020, examining the effect of probiotics in conditions applicable to individuals infected with COVID-19, including, but not limited to, other forms of coronavirus, critical illness, and mechanical ventilation. The databases search identified 1925 unique articles, 77 full-text articles were reviewed, and 48 studies were included in this scoping review, including 31 primary studies and 17 systematic reviews. Primary studies examined a range of interventions that varied by probiotic diversity and types, including 8 studies that focused on synbiotics, which include both pre-and probiotics. Several systematic reviews examined the effect of probiotics on ventilator-associated pneumonia and other infections. Although most systematic reviews concluded probiotics may improve these outcomes, most systematic review authors concluded that the evidence was low in quality and high in heterogeneity. In the absence of direct evidence with patients infected with COVID-19, studies in comparable populations are currently the best resource to guide probiotics interventions in conjunction with clinical expertise and multidisciplinary health care planning.
“…The databases and hand searches identified 1925 unique title or abstracts. Full texts of 77 studies were reviewed, and 48 studies were included in scoping review, including 17 systematic reviews, [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] 26 randomized controlled trials, and 5 nonrandomized controlled trials (including both nonrandomized controlled trials and observational studies) [65][66][67][68][69] (Figure 3). targeted adults who were critically ill and mechanically ventilated, and 5 articles 29,54,56,57,65 included individuals with various conditions, such as respiratory tract infections or influenza ( Figure 4).…”
Section: Resultsmentioning
confidence: 99%
“…The databases and hand searches identified 1925 unique title or abstracts. Full texts of 77 studies were reviewed, and 48 studies were included in scoping review, including 17 systematic reviews, 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 26 randomized controlled trials, 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 and 5 nonrandomized controlled trials (including both nonrandomized controlled trials and observational studies) 65 , 66 , 67 , 68 , 69 ( Figure 3 ). Figure 3 Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram for scoping review of literature examining the effects of probiotics on coronavirus disease 2019–related outcomes.…”
Section: Resultsmentioning
confidence: 99%
“…Of the 48 included articles, 23 articles 23 , 24 , 25 , 26 , 30 , 31 , 36 , 37 , 40 , 43 , 44 , 45 , 46 , 47 , 49 , 50 , 52 , 53 , 55 , 58 , 60 , 64 , 69 focused on participants who were critically ill but not mechanically ventilated, 20 articles 22 , 27 , 28 , 32 , 33 , 34 , 35 , 38 , 39 , 41 , 42 , 51 , 59 , 61 , 62 , 63 , 66 , 67 , 68 , 69 targeted adults who were critically ill and mechanically ventilated, and 5 articles 29 , 54 , 56 , 57 , 65 included individuals with various conditions, such as respiratory tract infections or influenza ( Figure 4 ). All articles focused on the adult population, which may include older adults, but none of them focused exclusively on older populations.…”
Section: Resultsmentioning
confidence: 99%
“…Seventeen systematic reviews and guidelines were included in this scoping review. 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 The authors’ conclusions and certainty of evidence for systematic reviews published from 2010 to 2020 are shown in Figure 7 . In these systematic reviews, authors’ conclusions are heterogeneous, though there were no systematic reviews describing high-quality evidence examining the effect of probiotics in the populations of interest.…”
Section: Resultsmentioning
confidence: 99%
“…In these systematic reviews, authors’ conclusions are heterogeneous, though there were no systematic reviews describing high-quality evidence examining the effect of probiotics in the populations of interest. Most of the systematic reviews describe that probiotics decreased incidence of ventilator-associated pneumonia, 26 , 27 , 28 , 34 , 35 , 36 although other systematic reviews that specifically focused on ventilator-associated pneumonia incidence concluded no beneficial effect from probiotics. 22 , 29 , 32 Several authors describe that intervention heterogeneity 22 , 25 , 26 , 29 , 32 , 34 , 36 or risk of bias 24 , 25 , 26 , 29 , 34 , 36 were a concern.…”
Probiotics have been suggested as a potential intervention for improving outcomes, particularly ventilatory-associated pneumonia, in patients infected with coronavirus disease 2019 (COVID-19). However, with the rapid development of the COVID-19 pandemic, there is little direct evidence available in infected patients. The objective of this scoping review is to examine the availability and nature of literature describing the effect of probiotics in adults with conditions or infections similar to COVID-19 infection on related health outcomes. MEDLINE, Cumulative Index to Nursing & Allied Health Literature, and Cochrane Databases were searched for studies published from 1999 to May 1, 2020, examining the effect of probiotics in conditions applicable to individuals infected with COVID-19, including, but not limited to, other forms of coronavirus, critical illness, and mechanical ventilation. The databases search identified 1925 unique articles, 77 full-text articles were reviewed, and 48 studies were included in this scoping review, including 31 primary studies and 17 systematic reviews. Primary studies examined a range of interventions that varied by probiotic diversity and types, including 8 studies that focused on synbiotics, which include both pre-and probiotics. Several systematic reviews examined the effect of probiotics on ventilator-associated pneumonia and other infections. Although most systematic reviews concluded probiotics may improve these outcomes, most systematic review authors concluded that the evidence was low in quality and high in heterogeneity. In the absence of direct evidence with patients infected with COVID-19, studies in comparable populations are currently the best resource to guide probiotics interventions in conjunction with clinical expertise and multidisciplinary health care planning.
Purpose of Review
Prebiotics, probiotics, and synbiotics have received increasing attention over the years for their beneficial impact on the gut microbiome and for their systemic anti-inflammatory effects. They have also been shown to improve surgical outcomes. Here, we review the inflammatory effects of surgery as well as the data which suggests a benefit of prebiotics, probiotics, and synbiotics taken in the perioperative period.
Recent Findings
Synbiotics and fermented foods may have an even greater anti-inflammatory effect than probiotics or prebiotics alone. Recent data suggest that the anti-inflammatory effects and microbiome changes brought on by prebiotics, probiotics, and synbiotics have the potential to improve surgical outcomes. We highlight the potential to alter systemic inflammation, surgical and hospital-acquired infections, colorectal cancer formation, recurrence, and anastomotic leak. Synbiotics could also impact metabolic syndrome.
Summary
Prebiotics, probiotics, and especially synbiotics may be extremely beneficial when taken in the perioperative period. Even short-term gut microbiome pre-habilitation could alter surgical outcomes significantly.
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