Anest. intenziv. Med. 2001;12(4):205-208

Lactulose and Impact on Microbial Colonization in Critically Ill PatientsArticles

V. Zvoníček¹, P. Ševčík¹, V. Šrámek¹, M. Votava², P. Ondrovčík², S. Zábranská²

Anesteziologicko-resuscitační klinika, LF MU, Fakultní nemocnice U sv. Anny v Brně, přednosta doc. MUDr. P. Ševčík, CSc.

Lactulose decreases pH of colon contents and can thus inhibit the overgrowth of pathogenic strains. In our study the impact of lactulose on microbialcolonisation of critically ill patients was investigated. Forty-eight mechanically ventilated patients with no signs of pneumonia on admission wererecruited into the prospective double-blind randomised study (15 ml lactulose versus saline q.i. d administered into the stomach). Gastric andoropharyngeal contents, tracheal aspirate and rectal swab were taken on admission and then at 3 day intervals. The concentration of pathogens> 105/ml was considered significant. Thirty-eight patients (15 given lactulose and 23 placebo) were mechanically ventilated > 5 days and were furtheranalysed. The colonisation of stomach and trachea were not statistically significant between the groups. The incidence of ventilatory pneumonia alsofailed to differ (40 and 35 %, respectively). The so called gastro-pulmonal route of infection was not confirmed. Oropharynx seems to be a major sourceof tracheal colonisation.

Keywords: ventilator associated pneumonia; lactulose; nasocomial infection; intensive care

Published: August 1, 2001  Show citation