Xiaofang Yang, Ruisheng Liu, Zhijing An, Boxia Li, Yanyan Lin, Yuanmin Li, Bing Song, Jinqiu Yuan, Wenbo Meng, Christian Waydhas
{"title":"益生菌减轻体外循环患者肠道低灌注相关的急性胃肠道损伤：一项随机对照试验","authors":"Xiaofang Yang, Ruisheng Liu, Zhijing An, Boxia Li, Yanyan Lin, Yuanmin Li, Bing Song, Jinqiu Yuan, Wenbo Meng, Christian Waydhas","doi":"10.1186/s12916-025-04082-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Acute gastrointestinal injury (AGI) after cardiopulmonary bypass (CPB) is associated with poor prognosis. This study aimed to evaluate the effect of preoperative probiotic supplementation on the incidence of AGI in patients undergoing CPB procedure.</p><p><strong>Methods: </strong>This was a double-blind, randomized controlled trial conducted in a single center. The patients undergoing HVR with CPB between September 2022 and February 2023 were randomly assigned to receive either probiotic (Lac group) or placebo (Placebo group). The probiotic was administered daily for seven days prior to surgery.Univariate and multivariate logistic regression analysis was performed to identify independent risk factors for AGI. A P-value < 0.05 was considered statistically significant. Gut microbiota composition was assessed using 16 s rRNA analysis.</p><p><strong>Results: </strong>A total of 52 patients were randomly assigned to two groups (26 in the Lac group, 26 in the Placebo group). Patients were followed for at least 30 days after surgery. During the follow-up period, 15 of the 52 patients (28.85%) developed AGI. The incidence of AGI was significantly lower in the Lac group (15.38%) compared to the Placebo group (42.31%), with a difference of 26.93% (P = 0.032). Moreover, patients in the Lac group had a significantly shorter ICU stay (6 [5, 36] vs. 5 [4, 5.5] days, P = 0.041) and a lower incidence of nosocomial infections (11.54% vs. 34.62%, P = 0.048). Multivariate analysis identified a higher Cardiac Surgery Score (CASUS) and CPB duration ≥ 132 min as independent risk factors for AGI, whereas probiotic supplementation was the only protective factor. Furthermore, 16S rRNA sequencing revealed significant differences in gut microbiota composition between the Lac and Placebo groups.</p><p><strong>Conclusions: </strong>Preoperative probiotic supplementation may be an effective strategy to reduce the incidence of AGI and AGI-related complications in CPB patients. These findings suggest that probiotics could be considered a preventive intervention for AGI in this patient population.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov: NCT05498948.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"238"},"PeriodicalIF":7.0000,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016265/pdf/","citationCount":"0","resultStr":"{\"title\":\"Probiotic mitigates gut hypoperfusion-associated acute gastrointestinal injury in patients undergoing cardiopulmonary bypass: a randomized controlled trial.\",\"authors\":\"Xiaofang Yang, Ruisheng Liu, Zhijing An, Boxia Li, Yanyan Lin, Yuanmin Li, Bing Song, Jinqiu Yuan, Wenbo Meng, Christian Waydhas\",\"doi\":\"10.1186/s12916-025-04082-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Acute gastrointestinal injury (AGI) after cardiopulmonary bypass (CPB) is associated with poor prognosis. This study aimed to evaluate the effect of preoperative probiotic supplementation on the incidence of AGI in patients undergoing CPB procedure.</p><p><strong>Methods: </strong>This was a double-blind, randomized controlled trial conducted in a single center. The patients undergoing HVR with CPB between September 2022 and February 2023 were randomly assigned to receive either probiotic (Lac group) or placebo (Placebo group). The probiotic was administered daily for seven days prior to surgery.Univariate and multivariate logistic regression analysis was performed to identify independent risk factors for AGI. A P-value < 0.05 was considered statistically significant. Gut microbiota composition was assessed using 16 s rRNA analysis.</p><p><strong>Results: </strong>A total of 52 patients were randomly assigned to two groups (26 in the Lac group, 26 in the Placebo group). Patients were followed for at least 30 days after surgery. During the follow-up period, 15 of the 52 patients (28.85%) developed AGI. The incidence of AGI was significantly lower in the Lac group (15.38%) compared to the Placebo group (42.31%), with a difference of 26.93% (P = 0.032). Moreover, patients in the Lac group had a significantly shorter ICU stay (6 [5, 36] vs. 5 [4, 5.5] days, P = 0.041) and a lower incidence of nosocomial infections (11.54% vs. 34.62%, P = 0.048). Multivariate analysis identified a higher Cardiac Surgery Score (CASUS) and CPB duration ≥ 132 min as independent risk factors for AGI, whereas probiotic supplementation was the only protective factor. Furthermore, 16S rRNA sequencing revealed significant differences in gut microbiota composition between the Lac and Placebo groups.</p><p><strong>Conclusions: </strong>Preoperative probiotic supplementation may be an effective strategy to reduce the incidence of AGI and AGI-related complications in CPB patients. These findings suggest that probiotics could be considered a preventive intervention for AGI in this patient population.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov: NCT05498948.</p>\",\"PeriodicalId\":9188,\"journal\":{\"name\":\"BMC Medicine\",\"volume\":\"23 1\",\"pages\":\"238\"},\"PeriodicalIF\":7.0000,\"publicationDate\":\"2025-04-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016265/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12916-025-04082-2\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12916-025-04082-2","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Probiotic mitigates gut hypoperfusion-associated acute gastrointestinal injury in patients undergoing cardiopulmonary bypass: a randomized controlled trial.
Background: Acute gastrointestinal injury (AGI) after cardiopulmonary bypass (CPB) is associated with poor prognosis. This study aimed to evaluate the effect of preoperative probiotic supplementation on the incidence of AGI in patients undergoing CPB procedure.
Methods: This was a double-blind, randomized controlled trial conducted in a single center. The patients undergoing HVR with CPB between September 2022 and February 2023 were randomly assigned to receive either probiotic (Lac group) or placebo (Placebo group). The probiotic was administered daily for seven days prior to surgery.Univariate and multivariate logistic regression analysis was performed to identify independent risk factors for AGI. A P-value < 0.05 was considered statistically significant. Gut microbiota composition was assessed using 16 s rRNA analysis.
Results: A total of 52 patients were randomly assigned to two groups (26 in the Lac group, 26 in the Placebo group). Patients were followed for at least 30 days after surgery. During the follow-up period, 15 of the 52 patients (28.85%) developed AGI. The incidence of AGI was significantly lower in the Lac group (15.38%) compared to the Placebo group (42.31%), with a difference of 26.93% (P = 0.032). Moreover, patients in the Lac group had a significantly shorter ICU stay (6 [5, 36] vs. 5 [4, 5.5] days, P = 0.041) and a lower incidence of nosocomial infections (11.54% vs. 34.62%, P = 0.048). Multivariate analysis identified a higher Cardiac Surgery Score (CASUS) and CPB duration ≥ 132 min as independent risk factors for AGI, whereas probiotic supplementation was the only protective factor. Furthermore, 16S rRNA sequencing revealed significant differences in gut microbiota composition between the Lac and Placebo groups.
Conclusions: Preoperative probiotic supplementation may be an effective strategy to reduce the incidence of AGI and AGI-related complications in CPB patients. These findings suggest that probiotics could be considered a preventive intervention for AGI in this patient population.
期刊介绍：
BMC Medicine is an open access, transparent peer-reviewed general medical journal. It is the flagship journal of the BMC series and publishes outstanding and influential research in various areas including clinical practice, translational medicine, medical and health advances, public health, global health, policy, and general topics of interest to the biomedical and sociomedical professional communities. In addition to research articles, the journal also publishes stimulating debates, reviews, unique forum articles, and concise tutorials. All articles published in BMC Medicine are included in various databases such as Biological Abstracts, BIOSIS, CAS, Citebase, Current contents, DOAJ, Embase, MEDLINE, PubMed, Science Citation Index Expanded, OAIster, SCImago, Scopus, SOCOLAR, and Zetoc.
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