Probiotics For Preventing Ventilator-associated Pneumonia In Mechanically Ventilated Patients:A Meta-analysis

Objective:Present study was conducted to comprehensively evaluate the effect of probiot-ics on ventilator-associated pneumonia and mortality in mechanically ventilated patients.Methods:Pubmed,OVID,Central on the Cochrane Library,CNKI,WanFang,WeiPu and the relate references were searched.Meta-analysis was performed by Revman5.3,the results were expressed as 95% confidence interval(95%CI)and average difference(MD).Measurements include the incidence of ventilator-associated pneumonia(VAP),length of Intensive Care Unit(ICU)stay,length of hospital stay,the duration of mechanical ventilation,mortality.According to the heterogeneity,we used random effect model or fixed effect model to analyze the data.Results:22 trials that enrolled 2908 mechanically ventilated(MV)patients were identified for analysis.Probiotics were associated with asignificant reduction in ventilator associated pneumonia(RR=0.58,95%CI [0.48,0.71],P<0.00001).Subgroup analysis suggests that probiotics significantly reduced the incidence of VAP in Asian humans,and reduced the incidence of VAP to some degree in Non-Asian population.It also can benefit children,newborns and adults in VAP.In addition,probiotics significantly shorten the duration of mechanical ventilation(MD=-1.18,95%CI[-1.89,-0.47],P=0.001).But no effect on length of ICU stay(MD=-1.81,95%CI[-4.18,0.55],P=0.13]),length of hospital stay(MD=-2.67,95%CI[-6.96,1.61],P=0.22)and mortality(RR=0.87,95%CI [0.73,1.05],P=0.14).Conclusion:Probiotics show no effect on length of hospital stay and mortality,while it show promise in reducing the incidence of VAP,short the duration of mechanical ventilatio-n.All of the indicators suggest the important value to improve the prognosis of mechanical ventilation patients.However,there are still many problems need to be solved by more high quality randomized controlled trials.