TY - JOUR T1 - Do probiotics help prevent ventilator-associated pneumonia in critically ill patients? A systematic review with meta-analysis JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00302-2020 VL - 7 IS - 1 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 - 2021/01/01 UR - http://openres.ersjournals.com/content/7/1/00302-2020.abstract N2 - Background Probiotic treatments might contribute to the prevention of ventilator-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 30 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-squared and I2 tests.Results 15 studies involving 2039 patients were identified for analysis. The pooled analysis suggests significant reduction on VAP (risk ratio, 0.68; 95% Cl, 0.60 to 0.77; p<0.00001) in a fixed-effects model. Subgroup analyses performed on the category of clinical and microbiological criteria both support the above conclusion; however, there were no significant differences in duration of MV or length of ICU stay in a random-effects model. Also, no significant differences in total mortality, overall mortality, 28-day mortality or 90-day mortality were found in the fixed-effects model.Conclusions The probiotics helped to prevent VAP without impacting the duration of MV, length of ICU stay or mortality.Pooled analysis suggests significant reduction in VAP in probiotic-treated patients but no change in the length of ICU stay, duration of mechanical ventilation or mortality https://bit.ly/30FfDTD ER -