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Controversies in the management of critically ill patients:The role of antioxidants and pre-, pro- and synbiotics Takeshi YAMANOUCHI 1 1Department of Pediatric Surgery Hospital of the University of Occupational and Environmental Health pp.281-286
Published Date 2019/4/1
DOI https://doi.org/10.11477/mf.3102200624
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Some micronutrients act as antioxidants if they are sufficiently supplemented. The effects of selenium and vitamin C on oxidative stress have been investigated in many critically ill patients. Selenium was initially reported to improve the prognosis of these patients, however large RCTs showed that its effect is limited. The effectiveness of vitamin C administered alone was controversial in critically ill patients, however the combination of vitamin C, thiamine and hydrocortisone has recently emerged as a potential adjunctive therapy in patients with sepsis. Several trials are ongoing to evaluate the impact of this combination therapy. There is a growing appreciation of the role of human microbiota in the pathophysiology of critical illness. A systematic review and meta-analysis demonstrated that pre-, pro- and synbiotic therapy significantly reduced the incidence of infectious complications in critically ill patients, however there was no reduction in mortality. Additional large-scale, adequately powered, well-designed clinical trials are needed to conclusively demonstrate the benefits of pre-, pro- and synbiotic therapy.


Copyright © 2019, MEDICAL SCIENCES INTERNATIONAL, LTD. All rights reserved.

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電子版ISSN 2186-7852 印刷版ISSN 1883-4833 メディカル・サイエンス・インターナショナル

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