Evidence map›Paper›PMID 20502866›Full record

Trial reportIntensive care medicine2010

Probiotics in the critically ill patient: a double blind, randomized, placebo-controlled trial.

Damien Barraud, Claire Blard, François Hein, Olivier Marçon, Aurélie Cravoisy, Lionel Nace, François Alla, Pierre-Edouard Bollaert, Sébastien Gibot

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Intensive care medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
53citing papers in PubMed, 15 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

53 citing papers in PubMed, 15 syntheses or guidelines pooled it.

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  12. Probiotics for preventing ventilator-associated pneumonia.The Cochrane database of systematic reviews · 2014
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Damien BarraudService de Réanimation Médicale, Hôpital Central, CHU Nancy, 29 avenue du Maréchal de Lattre de Tassigny, 54035, Nancy Cedex, France.
Claire Blard
François Hein
Olivier Marçon
Aurélie Cravoisy
Lionel Nace
François Alla
Pierre-Edouard Bollaert
Sébastien Gibot

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeProbiotics have been shown to be able to restore a non-pathogenic digestive flora, to prevent digestive colonization by pathogenic bacteria, and to modulate immunity. The aim of this study was to assess the effects of prophylactic probiotic administration in patients ventilated for up to 2 days.

methodsThis study was performed as a double-blind, concealed randomized, placebo-controlled trial in a French medical intensive care unit (ICU). Adult patients mechanically ventilated for a period of more than 48 h received enterally administered probiotics (Ergyphilus, 2 x 10(10) lactic acid bacteria, mostly Lactobacillus rhamnosus GG, once a day) or placebo until successful weaning.

resultsA total of 167 patients were included. The two groups were comparable at baseline. The 28-day mortality rates were not different in the probiotic (25.3%) and placebo groups (23.7%). Mortality rates in ICU and at 90 days were also unaffected by the treatment. The incidence of ICU-acquired infections did not differ significantly except for that of catheter-related bloodstream infections that was lowered by probiotics. On a prespecified subgroup analysis, we found a reduction of the 28-day mortality among severe sepsis patients (total n = 101) treated with probiotics (n = 52) with an odds ratio (OR) for death at 0.38 (95% CI 0.16-0.93, p = 0.035). By contrast, probiotics were associated with a higher mortality rate in non-severe sepsis patients (OR 3.09, 95% CI 0.87-11.01, p = 0.08).

conclusionsAlthough numerous uncertainties remain (type and the number of strains to use, delay and length of administration), and despite an acceptable safety profile, the daily prophylactic administration of probiotics cannot be encouraged in the critically ill patient.

Indexed as

Critical IllnessLacticaseibacillus rhamnosusAdultAgedCritical CareCross InfectionDouble-Blind MethodFemaleFranceHumansIntensive Care UnitsMaleMiddle AgedPneumonia, Ventilator-AssociatedProbioticsSeverity of Illness Index

Identifiers

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Registered trials

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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.