Dilek MEMİŞ, Birgül YELKEN, SEVTAP HEKİMOĞLU ŞAHİN, İlke VATAN, Tarık YARDIM

Ağır sepsis tedavisinde prebiyotik solüsyonların etkisi

Randomize, ileriye dönük ve çift kör bu çalışmada, enteral yolla verilen oligofrüktoz ve inülin içeren prebiyotik preparatin, ağır sepsisli yoğun bakım olgularında, üst gastrointestinal kolonizasyon ve sistemik enflamasyon üzerine etkileri araştırıldı. Hastalar ve Yöntemler: Yoğun bakım ünitesinde toplam 50 hastaya randomize olarak prebiyotik (grup 1, n=25) [Prebiyotik preparasyonu prebiyotik lif inülinoligofrüktoz içermektedir (0.8 g/100 mL, A, D3, E vitaminleri)] veya plasebo (grup 2, n=25) verildi. Gastrointestinal bariyer fonksiyonu, birinci ve sekizinci günlerdeki nazogastrik aspirat kültürü ile değerlendirildi. Tüm septik komplikasyonlar, akut fizyoloji ve kronik sağlık II skoru (APACHE II), ventilasyon süreleri, gastrointestinal kültür sonuçları, biyokimyasal değerler, C-reaktif protein (CRP) ve mortalite oranları kaydedildi. Bulgular: Gruplar aras›nda yaş, cinsiyet, APACHE II skorları, CRP, ventilasyon süreleri bakımından farklı lık saptanmadı. Gastrointestinal kültür, septik komplikasyonlar veya mortalite açısından gruplar arasında anlamlı farklılık yoktu. Sonuç: Prebiyotik solüsyonunun, ağır sepsisli yoğun bakım hastalarında kullanılmasının, gastrik kolonizasyon, gastrointestinal permeabilite, sistemik enflamatuvar yanıt ve morbidite üzerine etkisi olmadığı saptandı.

Anahtar Kelimeler:

Prebiyotikler, Yoğun bakım üniteleri, İnulin, Kritik hastalık, Sepsis, Rastgele kontrollü çalışmalar, Çift kör metot, Ölüm oranı, İleriye dönük çalışma

The effect of the prebiotic solutions in treatment of severe sepsis

In this double blind, prospective and randomized study, the effects of the enteral administration of a prebiotic preparation containing oligofructose and inulin on upper gastrointestinal colonization and systemic inflammation in intensive care patients with severe sepsis were investigated. Patients and Methods: A total of 50 patients admitted to an intensive care unit were randomized to receive either prebiotic (group 1, n=25) or placebo preparations (group 2, n=25). The prebiotic preparation consisted of prebiotic fiber inulin-oligofructose (0.8 g/100 mL, A, D3, E vitamins). Gut barrier function was assessed by culture of nasogastric aspirate on the first and eighth days. All septic complications, acute physiology and chronic health evaluation II (APACHE II) scores, ventilation days, gastrointestinal culture results, biochemical parameters, C-reactive protein (CRP) and mortality ratios were recorded. Results: There were no differences between the groups in terms of age, sex, APACHE II scores, CRP, ventilation days. There were no significant differences between the groups in terms of gastrointestinal culture, septic complications or mortality. Conclusion: The administration of prebiotic solution in intensive care patients with severe sepsis had no effect on gastrointestinal permeability, gastric colonisation, the systemic inflammatory response and morbidity.

Keywords:

Prebiotics, Intensive Care Units, Inulin, Critical Illness, Sepsis, Randomized Controlled Trial, Double-Blind Method, Mortality, Prospective Studies,

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