Synbiotics, Prebiotics, Glutamine, or Peptide in Early Enteral Nutrition: A Randomized Study in Trauma Patients

Spindler-Vesel, Alenka; Bengmark, S; Vovk, Irena; Cerović, Ognjen; Kompan, Lidija

doi:10.1177/0148607107031002119

Cited by 175 publications

(187 citation statements)

References 39 publications

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“…Indeed, bifidobacterial supplementation has been associated with lower bacterial translocation and endotoxaemia, leading to a decrease of the inflammatory cascade activation in several models of gut bacteria translocation [13][14][15]31]. Similarly, other studies have reported that probiotics and gut microbiota modulation through prebiotic ingestion may improve or prevent disruption of intestinal epithelial barrier function and consequently reduce intestinal permeability in rodents and humans [32,33]. Other studies strongly suggest that the products of OFS fermentation such as short-chain fatty acids (butyrate, propionate and lactate) positively influence the gut barrier function [34], i.e.…”

Section: Discussionmentioning

confidence: 97%

Selective increases of bifidobacteria in gut microflora improve high-fat-diet-induced diabetes in mice through a mechanism associated with endotoxaemia

et al. 2007

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Aims/hypothesis Recent evidence suggests that a particular gut microbial community may favour occurrence of the metabolic diseases. Recently, we reported that high-fat (HF) feeding was associated with higher endotoxaemia and lower Bifidobacterium species (spp.) caecal content in mice. We therefore tested whether restoration of the quantity of caecal Bifidobacterium spp. could modulate metabolic endotoxaemia, the inflammatory tone and the development of diabetes. Methods Since bifidobacteria have been reported to reduce intestinal endotoxin levels and improve mucosal barrier function, we specifically increased the gut bifidobacterial content of HF-diet-fed mice through the use of a prebiotic (oligofructose [OFS]). Results Compared with normal chow-fed control mice, HF feeding significantly reduced intestinal Gram-negative and Gram-positive bacteria including levels of bifidobacteria, a dominant member of the intestinal microbiota, which is seen as physiologically positive. As expected, HF-OFS-fed mice had totally restored quantities of bifidobacteria. HFfeeding significantly increased endotoxaemia, which was normalised to control levels in HF-OFS-treated mice. Multiple-correlation analyses showed that endotoxaemia significantly and negatively correlated with Bifidobacterium spp., but no relationship was seen between endotoxaemia and any other bacterial group. Finally, in HF-OFS-treated-mice, Bifidobacterium spp. significantly and positively correlated with improved glucose tolerance, glucose-induced insulin secretion and normalised inflammatory tone (decreased endotoxaemia, plasma and adipose tissue proinflammatory cytokines). Conclusions/interpretation Together, these findings suggest that the gut microbiota contribute towards the pathophysiological regulation of endotoxaemia and set the tone of inflammation for occurrence of diabetes and/or obesity. Thus, it would be useful to develop specific strategies for modifying gut microbiota in favour of bifidobacteria to prevent the deleterious effect of HF-diet-induced metabolic diseases.

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Section: Discussionmentioning

confidence: 97%

Selective increases of bifidobacteria in gut microflora improve high-fat-diet-induced diabetes in mice through a mechanism associated with endotoxaemia

et al. 2007

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“…There have been five randomized controlled trials of probiotic therapy as a strategy to prevent VAP (24,(32)(33)(34)(35). These studies had a mean sample size of 159 patients (range, 50-300) and an average APACHE II score of 17.…”

Section: Discussionmentioning

confidence: 99%

“…These studies had a mean sample size of 159 patients (range, 50-300) and an average APACHE II score of 17. Three of the studies used double blinding (24,32,35), and four analyzed singlecenter data (24,(32)(33)(34). Although four of the five studies showed trends toward reduced VAP rates in patients treated with probiotics, the difference was statistically significant in only two of the studies (34,35).…”

Section: Discussionmentioning

confidence: 99%

Probiotic Prophylaxis of Ventilator-associated Pneumonia

Morrow¹,

Kollef²,

Casale³

2010

Am J Respir Crit Care Med

312

329

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Rationale: Enteral administration of probiotics may modify the gastrointestinal environment in a manner that preferentially favors the growth of minimally virulent species. It is unknown whether probiotic modification of the upper aerodigestive flora can reduce nosocomial infections. Objectives: To determine whether oropharyngeal and gastric administration of Lactobacillus rhamnosus GG can reduce the incidence of ventilator-associated pneumonia (VAP). Methods: We performed a prospective, randomized, double-blind, placebo-controlled trial of 146 mechanically ventilated patients at high risk of developing VAP. Patients were randomly assigned to receive enteral probiotics (n 5 68) or an inert inulin-based placebo (n 5 70) twice a day in addition to routine care. Measurements and Main Results: Patients treated with Lactobacillus were significantly less likely to develop microbiologically confirmed VAP compared with patients treated with placebo (40.0 vs. 19.1%; P 5 0.007). Although patients treated with probiotics had significantly less Clostridium difficile-associated diarrhea than patients treated with placebo (18.6 vs. 5.8%; P 5 0.02), the duration of diarrhea per episode was not different between groups (13.2 6 7.4 vs. 9.8 6 4.9 d; P 5 0.39). Patients treated with probiotics had fewer days of antibiotics prescribed for VAP (8.6 6 10.3 vs. 5.6 6 7.8 d; P 5 0.05) and for C. difficile-associated diarrhea (2.1 6 4.8 SD d vs. 0.5 6 2.3 d; P 5 0.02). No adverse events related to probiotic administration were identified. Conclusions: These pilot data suggest that L. rhamnosus GG is safe and efficacious in preventing VAP in a select, high-risk ICU population. Clinical trial registered with www.clinicaltrials.gov (NCT00613795).

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“…However, most of these previous reports did not examine the changes in the gut flora that resulted from the synbiotic therapy [1][2][3][6][7][8][9][10][11][12].…”

Section: Discussionmentioning

confidence: 99%

“…Previous reports have described the effects of probiotics/synbiotics for general infectious complications in various patients, such as liver transplantation [1,2], major abdominal surgery [3][4][5], severe acute pancreatitis [6][7][8], trauma [9,10], and critically ill patients [11][12][13]. However, these reports generally did not examine changes in the gut flora following probiotic/synbiotic therapy [1][2][3][6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Synbiotic Therapy Reduces the Pathological Gram-Negative Rods Caused by an Increased Acetic Acid Concentration in the Gut

et al. 2012

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Synbiotics, Prebiotics, Glutamine, or Peptide in Early Enteral Nutrition: A Randomized Study in Trauma Patients

Abstract: Patients supplemented with synbiotics did better than the others, with lower intestinal permeability and fewer infections.

Cited by 175 publications

References 39 publications

Selective increases of bifidobacteria in gut microflora improve high-fat-diet-induced diabetes in mice through a mechanism associated with endotoxaemia

Selective increases of bifidobacteria in gut microflora improve high-fat-diet-induced diabetes in mice through a mechanism associated with endotoxaemia

Probiotic Prophylaxis of Ventilator-associated Pneumonia

Synbiotic Therapy Reduces the Pathological Gram-Negative Rods Caused by an Increased Acetic Acid Concentration in the Gut

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