Probiotics and diarrhoea management in enterally tube fed critically ill patients—–What is the evidence?

Jack, Leanne, Coyer, Fiona, Courtney, Mary and Venkatesh, Bala (2010) Probiotics and diarrhoea management in enterally tube fed critically ill patients—–What is the evidence?. Intensive and Critical Care Nursing, 26 6: 314-326. doi:10.1016/j.iccn.2010.07.001

Author Jack, Leanne
Coyer, Fiona
Courtney, Mary
Venkatesh, Bala
Title Probiotics and diarrhoea management in enterally tube fed critically ill patients—–What is the evidence?
Journal name Intensive and Critical Care Nursing   Check publisher's open access policy
ISSN 0964-3397
Publication date 2010-12
Sub-type Article (original research)
DOI 10.1016/j.iccn.2010.07.001
Volume 26
Issue 6
Start page 314
End page 326
Total pages 13
Place of publication Newcastle, United Kingdom
Publisher Churchill Livingstone
Collection year 2011
Language eng
Formatted abstract
Objective: The aim of this literature review is to identify the role of probiotics in the management of enteral tube feeding (ETF) diarrhoea in critically ill patients.
Background: Diarrhoea is a common gastrointestinal problem seen in ETF patients. The incidence of diarrhoea in tube fed patients varies from 2% to 68% across all patients. Despite extensive investigation, the pathogenesis surrounding ETF diarrhoea remains unclear. Evidence to support probiotics to manage ETF diarrhoea in critically ill patients remains sparse.
Method: Literature on ETF diarrhoea and probiotics in critically ill, adult patients was reviewed from 1980 to 2010. The Cochrane Library, Pubmed, Science Direct, Medline and the Cumulative Index of Nursing and Allied Health Literature (CINAHL) electronic databases were searched using specific inclusion/exclusion criteria. Key search terms used were: enteral nutrition, diarrhoea, critical illness, probiotics, probiotic species and randomised clinical control trial (RCT).
Results: Four RCT papers were identified with two reporting full studies, one reporting a pilot RCT and one conference abstract reporting an RCT pilot study. A trend towards a reduction in diarrhoea incidence was observed in the probiotic groups. However, mortality associated with probiotic use in some severely and critically ill patients must caution the clinician against its use.
Conclusion: Evidence to support probiotic use in the management of ETF diarrhoea in critically ill patients remains unclear. This paper argues that probiotics should not be administered to critically ill patients until further research has been conducted to examine the causal relationship between probiotics and mortality, irrespective of the patient's disease state or projected prophylactic benefit of probiotic administration.
© 2010 Elsevier Ltd.
Keyword Enteral nutrition
Critical illness
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Medicine Publications
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Created: Fri, 18 Mar 2011, 13:42:57 EST by Debbie Banks on behalf of Anaesthesiology and Critical Care - RBWH