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Probiotikas inverkan på sjukdomsförloppet hos intensivvårdspatienter.: En metaanalys till grund för evedensbaserad omvårdnad
Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
2011 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
Abstract [sv]

Bakgrund och syfte: Intresset för enteral administrering av probiotika i förebyggandet av infektioner och diarré har på senare tid ökat. Nosokomiala infektioner och diarré är ett stort problem hos intensivvårdpatienter.  Syftet med denna studie var att undersöka hur enteral probiotika påverkar sjukdomsförloppet hos intensivvårdspatienter, med avseende på mortalitet, infektioner totalt, ventilatorassocierad pneumoni (VAP) och diarré.

Metod: En systematisk litteraturstudie med sökning i Pubmed och Cinahl genomfördes med följande Meshtermer; probiotics, lactobacillus, critical illness och intensive care unit. Därefter genomfördes en metaanalys av randomiserade kontrollerade studier, utförda på vuxna intensivvårdspatienter, där man jämfört patienter som erhållit probiotika med patienter som fått placebo eller annan behandling.

Resultat: Totalt 15 studier med sammanlagt 1293 patienter inkluderades. Ingen signifikans med avseenden på mortalitet, infektioner totalt, VAP och diarré kunde utläsas i metaanalysen. En trend mot en minskning av infektioner totalt (p=0,075) och VAP (p=0,090) i probiotikagruppen var dock tydlig.

Konklusion: Probiotika kan komma att ha en betydande roll inom intensivvården i framtiden, då det förefaller ha en positiv effekt på infektionsfrekvensen. I dagsläget finns emellertid ej tillräckligt vetenskapligt stöd för användning av probiotika i behandlingen

intensivvårdspatienter. Det behövs större och väl genomförda randomiserade multicenterstudier.

Abstract [en]

Background and aim: The interest in enteral administration of probiotics to prevent infections and diarrhea has recently arisen. Nosocomial infections and diarrhea are common problems among intensive care unit patients. The aim of this study was to investigate how enteral probiotics influence the course of intensive care unit patients with focus on mortality, total infections, ventilator associated pneumonia (VAP) and diarrhea.

Method: A systematic literature review was undertaken. Pubmed and Cinahl were searched using the following Meshterms; probiotics, lactobacillus, critical illness and intensive care unit. Thereafter a meta-analysis was conducted combining the results of the randomized controlled trials that compared a group of adult intensive care unit patients taking probiotics with a group that did not.

Result: A total of 15 studies with a total of 1293 patients were included. For mortality, total infections, VAP and diarrhea no significance was detected in the meta-analysis. However a trend towards a decrease in over all infections (p=0.075) and VAP (p=0,090) in the probiotic group was seen.

Conclusion: In the future the probiotics may play an important role in the field of intensive care, as it seems to confer a positive effect on infection rates. However, there is currently a lack of conclusive evidence to support the use of probiotics in the treatment of intensive care unit patients. Larger well designed randomized multicentre studies are required

Place, publisher, year, edition, pages
2011.
Keyword [en]
: Intensive Care Unit, Meta-Analysis, Nursing, Probiotics, Randomized Controlled Trials
Keyword [sv]
: intensivvårdsavdelning, metaanalys, omvårdnad, probiotika, randomiserade kontrollerade studier
Identifiers
URN: urn:nbn:se:miun:diva-14032OAI: oai:DiVA.org:miun-14032DiVA: diva2:424497
Uppsok
Medicine
Supervisors
Examiners
Available from: 2011-07-11 Created: 2011-06-17 Last updated: 2011-07-11Bibliographically approved

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