Effect of gut microbiota modulation on feeding tolerance of enterally fed critically ill adult patients: a systematic review

Systematic Reviews

Alireza Sedaghat¹  Majid Khadem-Rezaiyan²  Ali Jafarzadeh Esfahani³  Reza Rezvani³  Najmeh Seifi³  Mohsen Nematy⁴  Mohammad Safarian⁴ 

[1] Department of Anesthesiology, Mashhad University of Medical Sciences, Mashhad, Iran;Department of Community Medicine, Medical School, Mashhad University of Medical Sciences, Mashhad, Iran;Department of Nutrition, Medical School, Mashhad University of Medical Sciences, Mashhad, Iran;Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran;

关键词: Prebiotics;    Probiotics;    Synbiotics;    Gut microbiota;    Feeding tolerance;    Critical care;   

DOI  :  10.1186/s13643-021-01633-5

来源: Springer

【 摘 要 】

PurposeThe objective of this systematic review was to evaluate the effect of pre-, pro-, and synbiotics on feeding tolerance of enterally fed critically ill adult patients.MethodsMEDLINE, Science Direct, Web of Knowledge, and the Cochrane Central Register of Controlled Trials were searched up to November 2019. English language randomized controlled trials reporting the effect of pre, pro or synbiotics on the feeding tolerance of enterally fed critically ill adult patients were included.ResultsOverall, 15 papers were selected for review. Among six studies reporting the energy intake, only two studies showed significantly higher energy intake in the prebiotic-receiving groups. Among four RCTs reporting frequency or time to achieve the target calorie, only one found a significant effect of probiotics to reduce the time to achieve a target dose of calorie. About the prevalence or duration of diarrhea, 7 out of 12 RCTs reported a beneficial effect. All but one study found no beneficial effects for gut microbiota manipulation on clinical endpoints including length of stay (LOS) in hospital and intensive care unit (ICU).ConclusionIt should be noticed that the heterogeneity in study designs, product format, and ICU patient populations makes it difficult to draw any general conclusion. Overall, it seems that pre, pro, or synbiotics have no significant beneficial effect on feeding tolerance and clinical endpoints in critically ill adults, but they may reduce the prevalence or duration of diarrhea.

【 授权许可】

CC BY