Effects of probiotics on blood glucose levels and clinical outcomes in patients with severe craniocerebral trauma

Abstract

To investigate the effects of probiotics on blood glucose levels and clinical outcomes in patients suffering from severe craniocerebral trauma. A prospective randomized control study was conducted. Fifty-two severe craniocerebral trauma patients admitted to intensive care unit (ICU) were randomized into experimental or control group (each n=26). All patients received conventional treatment according to Guidelines for the Clinical Management of Traumatic Brain Injury and enteral nutrition within 24-48 hours after admission through nasogastric tube. In addition, the experimental group received 1×10(9) bacteria of viable probiotics (Golden Bifid, 3.5 g for 3 times per day) per day for 21 days. The fasting blood glucose levels were determined in the morning before intervention and on day 4, 8, 15, 21 after intervention. Amount of insulin used during hospitalization, Glasgow coma scale (GCS) scores, length of ICU stay, and 28-day mortality rate were studied. There was no difference in term of the blood glucose levels between two groups before intervention. On day 8 and 15 after intervention, significantly lower levels of fasting blood glucose were observed in the experimental group compared with those of the control group (8 days: 6.6±1.2 mmol/L vs. 8.0±2.7 mmol/L, t=-2.500, P=0.017; 15 days: 6.1±1.4 mmol/L vs. 7.2±2.2 mmol/L, t=-2.269, P=0.028). There were significantly less patients treated with insulin or shorter days of insulin therapy in experimental group than in control group [19.2% (5/26) vs. 46.2% (12/26), χ(2)=4.282, P=0.039; 1.6±0.9 vs. 4.3±3.1, t=-2.698, P=0.017]. The length of ICU stay was significantly shorter in the experimental group than that of control group (6.8±3.8 days vs. 10.7±7.3 days, t=-2.123, P=0.034). No significant differences were found about the GCS scores (before intervention: 6.3±1.0 vs. 6.4±1.0, t=-0.408, P=0.685; 21 days after intervention: 10.1±4.0 vs. 9.6±4.3, t=0.435, P=0.665) and 28-day mortality rate [11.5% (3/26) vs. 19.2% (5/26), χ(2)=0.148, P=0.701] between experimental group and control group. Probiotics could facilitate blood glucose control in patients with severe craniocerebral injury. The underlying mechanisms and its long-term efficacy in this category of patients, however, need to be further investigated.