Effect of a probiotic preparation (VSL#3) in critically ill patients: A randomized, double-blind, placebo-controlled trial (Pilot Study)

Abstract

Objective : Reactive oxygen species (ROS) are a major contributing factor in diseases pathophysiology in critically ill patients. Oxidative stress usually occurs in critical illnesses, specifically during sepsis, and organ dysfunction. The anti-oxidative properties of probiotics may serve as a defense in intestine and overcome various oxidative stresses. The aim of this trial was to determine the effect of probiotics on inflammation, antioxidant capacity and lipid peroxidation in critically ill patients. Methodology : Forty patients admitted to the intensive care unit were enrolled in this double-blind, randomized controlled trial. They were randomized to receive placebo or probiotic for 7 days. Serum levels of Total Antioxidant Capacity (TAC), Malodialdehyde (MDA), C-Reactive Protein (CRP) and Acute Physiology and Chronic Health Evaluation (APACHE II) score were measured before initiation of the study and on the 7(th) day.

Results: There was a significant difference in CRP levels and APACHE II score between two groups at the end of the study (P= 0.003 and 0.001, respectively). There was not a significant difference in levels of TAC and MDA between two groups.

Conclusions: Administration of probiotics to critically ill patients caused reduction in inflammation and improvement of clinical outcome. However, there were not significant changes in markers of oxidative stress.

Keywords: Critically ill; Oxidative stress; Probiotic; Sepsis.

Fig.1

Mean (±SD) CRP levels in two groups of patients. *Patients in the probiotic group had significantly lower CRP levels by day 7 (P =0.006