Trial reportIntensive care medicine2009
Effect of synbiotic therapy on the incidence of ventilator associated pneumonia in critically ill patients: a randomised, double-blind, placebo-controlled trial.
Trial report in Intensive care medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 13 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
47 citing papers in PubMed, 13 syntheses or guidelines pooled it, 128 citations in OpenAlex.
- Role of probiotic supplementation in preventing ventilator-associated pneumonia among critically ill patients-a critical umbrella review of meta-analyses of randomized controlled trials.Frontiers in nutrition · 2025Pooled it
- The safety and efficacy of probiotic supplementation for critically ill adult patients: a systematic review and meta-analysis.Nutrition reviews · 2023Pooled it
- Probiotic in the prevention of ventilator-associated pneumonia in critically ill patients: evidence from meta-analysis and trial sequential analysis of randomized clinical trials.BMC pulmonary medicine · 2022Pooled it
- Pooled it
- Probiotic Supplementation Prevents the Development of Ventilator-Associated Pneumonia for Mechanically Ventilated ICU Patients: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials.Frontiers in nutrition · 2022Pooled it
- Effect of gut microbiota modulation on feeding tolerance of enterally fed critically ill adult patients: a systematic review.Systematic reviews · 2021Pooled it
- Synbiotic Therapy Prevents Nosocomial Infection in Critically Ill Adult Patients: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials Based on a Bayesian Framework.Frontiers in medicine · 2021Pooled it
- Clinical Benefits From Administering Probiotics to Mechanical Ventilated Patients in Intensive Care Unit: A PRISMA-Guided Meta-Analysis.Frontiers in nutrition · 2021Pooled it
- Probiotic and synbiotic therapy in critical illness: a systematic review and meta-analysis.Critical care (London, England) · 2016Pooled it
- Probiotics for preventing ventilator-associated pneumonia.The Cochrane database of systematic reviews · 2014Pooled it
- Use of probiotics in the treatment of severe acute pancreatitis: a systematic review and meta-analysis of randomized controlled trials.Critical care (London, England) · 2014Pooled it
- Pooled it
- Probiotics' effects on the incidence of nosocomial pneumonia in critically ill patients: a systematic review and meta-analysis.Critical care (London, England) · 2012Pooled it
- Synbiotics modulate gut microbiota and reduce enteritis and ventilator-associated pneumonia in patients with sepsis: a randomized controlled trial.Critical care (London, England) · 2018Trial
- Effect of probiotics on the incidence of ventilator-associated pneumonia in critically ill patients: a randomized controlled multicenter trial.Intensive care medicine · 2016Trial
- Synbiotic therapy reduces the pathological gram-negative rods caused by an increased acetic acid concentration in the gut.Digestive diseases and sciences · 2012Trial
- Effects of probiotics on serum levels of Th1/Th2 cytokine and clinical outcomes in severe traumatic brain-injured patients: a prospective randomized pilot study.Critical care (London, England) · 2011Trial
- Probiotic prophylaxis of ventilator-associated pneumonia: a blinded, randomized, controlled trial.American journal of respiratory and critical care medicine · 2010Trial
- Gastrointestinal Tolerance toIndian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026Article
- Arms-Based Meta-Analysis of Microbiological Endpoints of 88 VAP Prevention Studies Using Antimicrobial Versus Non-Antimicrobial Strategies-Towards 'VAP-Zero'?Antibiotics (Basel, Switzerland) · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate the effect of enteral Synbiotic 2000 FORTE (a mixture of lactic acid bacteria and fibre) on the incidence of ventilator associated pneumonia (VAP) in critically ill patients.
designProspective, randomised, double blind, placebo controlled trial.
settingTertiary referral centre, general Adult Intensive Care Unit (ICU). PATIENTS AND
participants259 enterally fed patients requiring mechanical ventilation for 48 h or more were enrolled.
interventionAll patients were enterally fed as per a standard protocol and randomly assigned to receive either synbiotic 2000 FORTE (twice a day) or a cellulose-based placebo for a maximum of 28 days. MEASUREMENTS AND
resultsTreatment group (n = 130) was well matched with placebo group (n = 129) for age (mean 49.5 and 50 years, respectively) and APACHE II score (median 17 for both). Oropharyngeal microbial flora and colonisation rates were unaffected by synbiotics. The overall incidence of VAP was lower than anticipated (11.2%) and no statistical difference was demonstrated between groups receiving synbiotic and placebo in the incidence of VAP (9 and 13%, P = 0.42), VAP rate per 1,000 ventilator days (13 and 14.6, P = 0.91) or hospital mortality (27 and 33%, P = 0.39), respectively.
conclusionsEnteral administration of Synbiotic 2000 FORTE has no statistically significant impact on the incidence of VAP in critically ill patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.