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Correspondence |

Probiotics in Critically Ill PatientsProbiotics in Critically Ill Patients: More Data Are Needed FREE TO VIEW

Wan-Jie Gu, MSc; Jing-Chen Liu, MD
Author and Funding Information

From the Department of Anaesthesiology, the First Affiliated Hospital of Guangxi Medical University.

Correspondence to: Jing-Chen Liu, MD, Department of Anaesthesiology, the First Affiliated Hospital of Guangxi Medical University, 22 Shuangyong Rd, Nanning 530021, Guangxi, China; e-mail: jingchenliu1964@yahoo.com.cn


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(3):873-874. doi:10.1378/chest.12-2544
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Published online
To the Editor:

We read with great interest the article by Barraud et al1 in this issue of CHEST (see page 646) discussing the effects of probiotics on mortality in critically ill adult patients. We congratulate them and applaud their work, but we feel a couple of issues must be addressed.

First, in the “Selection of Studies” section the authors declared that randomized controlled trials were potentially evaluated if they enrolled critically ill adult patients admitted into an ICU and compared the administration of probiotics (and/or prebiotics or synbiotics) and control (placebo or other), and that the articles must also have reported on ICU or hospital mortality. Was that the inclusion/exclusion criteria of their report? If so, why did they not include the trial conducted by Giamarellos-Bourboulis et al?2 The authors should have given a more detailed description of the inclusion/exclusion criteria.

Second, the meta-analysis also evaluated the effects of probiotics on secondary outcomes, including all-cause hospital mortality, incidence of ICU-acquired infection, incidence of diarrhea, duration of mechanical ventilation, and ICU and hospital length of stay. In fact, these results are not conclusive because the examination of the effects of probiotics on these end points was not adequately powered. They were not regarded as the primary outcome but were the only clinically significant end points consistently reported in some of the studies included in this meta-analysis. More data are needed to clarify these questions in essence instead of inform.

References

Barraud D, Bollaert P-E, Gibot S. Impact of the administration of probiotics on mortality in critically ill adult patients: a meta-analysis of randomized controlled trials. Chest. 2013;143(3):646-655.
 
Giamarellos-Bourboulis EJ, Bengmark S, Kanellakopoulou K, Kotzampassi K. Pro- and synbiotics to control inflammation and infection in patients with multiple injuries. J Trauma. 2009;67(4):815-821. [CrossRef] [PubMed]
 

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References

Barraud D, Bollaert P-E, Gibot S. Impact of the administration of probiotics on mortality in critically ill adult patients: a meta-analysis of randomized controlled trials. Chest. 2013;143(3):646-655.
 
Giamarellos-Bourboulis EJ, Bengmark S, Kanellakopoulou K, Kotzampassi K. Pro- and synbiotics to control inflammation and infection in patients with multiple injuries. J Trauma. 2009;67(4):815-821. [CrossRef] [PubMed]
 
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