• Zhiling Gao, Shuomiao Yin, Kui Jin, Weiqun Nie, Longmei Wang, and Ling Cheng.
• Department of Intensive Care Unit, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui Province, China.
• Medicine (Baltimore). 2023 Dec 15; 102 (50): e36454e36454.

BackgroundThis meta-analysis aimed to assess the efficacy and safety of probiotics in conjunction with early enteral nutrition for the treatment of severe acute pancreatitis (SAP). This study focused on multiple clinical endpoints, including mortality rate, risk of organ failure, and duration of hospital stay.MethodsIn accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study adhered to the Patient, Intervention, Comparison, Outcome framework and utilized randomized controlled trials to examine the impact of probiotics on patients with SAP. Data extraction and quality assessment were conducted independently by 2 evaluators, with discrepancies resolved collaboratively, or by a third adjudicator. Statistical analyses were performed using chi-square statistics, I2 metrics, and both fixed- and random-effects models, as dictated by heterogeneity levels.ResultsThe meta-analysis covered 6 randomized controlled trials. Compared to control groups (placebo or standard care without probiotics), probiotics did not significantly reduce mortality rates or organ failure risk. However, they notably shortened hospital stays by a weighted mean difference of -5.49 days (95% confidence interval: -10.40 to -0.58; P = .010). The overall bias risk was low to moderate.ConclusionsProbiotics combined with early enteral nutrition did not significantly improve mortality rates or reduce the risk of organ failure in patients with SAP, but shortened hospital stays. Further studies are required to corroborate these findings.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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