Synbiotics reduce infectious complications by improving the intestinal milieu and enhancing the immune function in critically ill emergency surgical patients

Objective: To determine the effects of synbiotics upon the intestinal milieu, immune response, and infection in critically ill patients. Methods: Thirty-two critically ill patients, who had undergone emergency surgery, were divided into two groups, those who started receiving enteral synbiotics (Lactobacillus casei strain Shirota and Bifidobacterium breve strain Yakult plus galactooligosaccharides; group S, n = 20) and those who did not receive enteral synbiotics (the control, group C, n = 12) within 48 hours of admission to the ICU and continuing for 14 days. Results: Baseline values were comparable between the two groups. NK (natural killer) cell activity and lymphocyte counts significantly increased in group S. C-reactive protein concentrations significantly decreased in both groups. White blood cell counts significantly decreased in group S, but remained unchanged in group C. Group S had more Bifidobacterium and Lactobacillus and less Pseudomonas than group C in the stool samples after the trial. Concentrations of fecal organic, acetic, and propionic acids were significantly greater and the incidences of infectious complications were significantly lower in group S (25% vs. 75%, P < 0.01). The ICU stay was significantly shorter for group S. None of the patients died or developed adverse events. Conclusions: Synbiotics enhanced host immune function in critically ill emergency surgical patients, improved the intestinal milieu, and decreased the incidence of infectious complications.