Probiotics in Critically Ill Patients: An Umbrella Review.

Objectives: Probiotics are live microorganisms which when administered in adequate amounts confer a health benefit on the host. Because of the wide usage of antibiotics, acute changes in diet, and the stress of illness, critically ill patients' homeostasis of the gut microbiome can be disrupted during intensive care unit (ICU) confinement; probiotics are suggested as a beneficial intervention in critically ill patients. We tried to give an overview of the effects of probiotic supplements in critically ill patients based on published systematic reviews (SRs) and meta-analyses (MAs). Data sources: A systematic search was performed in four databases as well as hand searching. Study selection: The results were independently screened in two title/abstracts and full-text stages. Data extraction: Any reported outcomes in each study were extracted, using a data extraction table. Data synthesis: A wide range of outcomes of using probiotic supplements in critically ill patients have been reported in 20 included studies. Based on the current knowledge, we can say that probiotics may reduce the rate of ventilator-associated pneumonia, nosocomial pneumonia, the overall infection rate, duration of mechanical ventilation, and antibiotic use in critically ill patients, but there is not a significant association between using the probiotics and mortality, length of hospitalization, and incidence of diarrhea. Conclusion: Despite the various beneficial effects of probiotics in critically ill patients, there is not yet much evidence supporting the routine use of these supplements and further well-designed multicenter trials are needed to provide "evidence-based" recommendations. How to cite this article: Naseri A, Seyedi-Sahebari S, Mahmoodpoor A, Sanaie S. Probiotics in Critically Ill Patients: An Umbrella Review. Indian J Crit Care Med 2022;26(3):339-360.