TY - JOUR T1 - Do probiotics help prevent ventilator-associated pneumonia in the critically ill patients? A systematic review with meta-analysis JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00302-2020 SP - 00302-2020 AU - Jie Zhao AU - Lei-qing Li AU - Cheng-yang Chen AU - Gen-sheng Zhang AU - Wei Cui AU - Bao-ping Tian Y1 - 2020/01/01 UR - http://openres.ersjournals.com/content/early/2020/10/01/23120541.00302-2020.abstract N2 - Background Probiotic treatments might contribute to the prevention of ventilation-associated pneumonia (VAP). Due to its unclear clinical effects, here we intend to assess the preventive effect and safety of probiotics on Intensive Care Unit (ICU) patients.Methods Eligible randomised controlled trials were selected in databases until 31 September 2019. The characteristics of the studies were extracted, including study design, definition of VAP, probiotics intervention, category of included patients, incidence of VAP, mortality, duration of mechanical ventilation(MV) and ICU stay. Heterogeneity was evaluated by Chi-square and I2 tests.Results 15 studies involving 2039 patients were identified for analysis. The pooled analysis suggests significant reduction on VAP (RR, 0.68; 95%Cl, 0.60 to 0.77; p<0.00001) in a fixed effect model. And subgroup analysis was performed on category of clinical and microbiogical criteria both support the above conclusion. However, no significant difference in duration of MV or length of ICU stay in a random effect model. Also, no significant differences in total mortality, overall mortality, 28-day mortality, 90-day mortality were found in the fixed effect model.Conclusions The probiotics helped prevent VAP without impacting duration of mechanical ventilation, length of ICU stay, or mortality.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Jie ZhaoConflict of interest: Lei-qing LiConflict of interest: Cheng-yang ChenConflict of interest: Gen-sheng ZhangConflict of interest: Wei CuiConflict of interest: Bao-ping Tian ER -