Probiotics in the intensive care unit

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Probiotics are living microorganisms that, when ingested in adequate amounts, provide benefits to the host. The benefits include either a shortened duration of infections or decreased susceptibility to pathogens. Proposed mechanisms of beneficial effects include improving gastrointestinal barrier function, modification of the gut flora by inducing host cell antimicrobial peptides and/or local release of probiotic antimicrobial factors, competition for epithelial adherence, and immunomodulation. With increasing intensive care unit (ICU) antibacterial resistance rates and fewer new antibiotics in the research pipeline, focus has been shifted to non-antibiotic approaches for the prevention and treatment of nosocomial infections. Probiotics offer promise to ICU patients for the prevention of antibiotic-associated diarrhea, Clostridium difficile infections, multiple organ dysfunction syndrome, and ventilator-associated pneumonia. Our current understanding of probiotics is confounded by inconsistency in probiotic strains studied, optimal dosages, study durations, and suboptimal sample sizes. Although probiotics are generally safe in the critically ill, adverse event monitoring must be rigorous in these vulnerable patients. Delineation of clinical differences of various effective probiotic strains, their mechanisms of action, and optimal dosing regimens will better establish the role of probiotics in various disorders. However, probiotic research will likely be hindered in the future given a recent ruling by the U.S. Food and Drug Administration.

Original languageEnglish
Pages (from-to)235-241
Number of pages7
JournalNutrition in Clinical Practice
Volume27
Issue number2
DOIs
StatePublished - Apr 2012

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Probiotics
Intensive Care Units
Anti-Bacterial Agents
Clostridium Infections
Ventilator-Associated Pneumonia
Immunomodulation
Multiple Organ Failure
Clostridium difficile
United States Food and Drug Administration
Cross Infection
Research
Critical Illness
Sample Size
Diarrhea
Peptides
Infection

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Probiotics in the intensive care unit. / Morrow, Lee E.; Gogineni, Vijaya; Malesker, Mark A.

In: Nutrition in Clinical Practice, Vol. 27, No. 2, 04.2012, p. 235-241.

Research output: Contribution to journalArticle

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