Abstract
Introduction: There is evidence of the curing effects of prebiotics in promoting growth of bifid bacterium in the digestive system and the central role of bacteria colonization in the pathogenesis of ventilator-associated pneumonia (VAP). The purpose of this study was to evaluate the effects of administration of a prebiotic, namely fenugreek seeds, on VAP prevention and clinical outcomes in critically ill patients.
 Methods: In this study, 60 mechanically ventilated patients were randomly divided into 2 groups (n=30 per group). Group 1 was given fenugreek seed powder by gavage, twice a day in addition to routine care, while group 2 received only routine care. Demographic and clinical data were recorded and clinical responses to the primary component (prevalence of VAP) and secondary component (other clinical factors) were interpreted. Data were analyzed via SPSS v.20, using student t-test, chi-square test, repeated measure ANOVA, and Wilcoxon test.
 Result: There was a significant reduction of patients diagnosed with VAP, as well as clostridium difficileassociated diarrhea and some complications of mechanical ventilation, in group 1 when compared to group 2. In addition, improvement in VAP was significantly greater for group 1 as compared with group 2. Mortality rates were not different between the two groups.
 Conclusion: The present study demonstrated that daily diet with fenugreek seeds can be used as an add-on therapy with other medications in prevention of VAP. As a result, the use of fenugreek seeds in the treatment plan of patients undergoing long-term intubation is recommended.
Highlights
There is evidence of the curing effects of prebiotics in promoting growth of bifid bacterium in the digestive system and the central role of bacteria colonization in the pathogenesis of ventilator-associated pneumonia (VAP)
The results indicated that boiling water extract contains antimicrobial activity against gram-negative and gram-positive bacteria, and other microorganisms, such as Escherichia coli (E. coli), Proteus vulgaris (P. vulgaris), Staphylococcus aureus (St. aureus), Candida albicans (C. albicans), Staphylococcus epidermis (St. epidermis), and Staphylococcus saprophyticus [14]
The present study demonstrated that the use of fenugreek seeds has favorable effects on VAP, clostridium difficile-associated diarrhea, and other clinical outcomes (e.g. MV duration, length of stay in intensive care unit (ICU) of the critically ill patients, etc.)
Summary
There is evidence of the curing effects of prebiotics in promoting growth of bifid bacterium in the digestive system and the central role of bacteria colonization in the pathogenesis of ventilator-associated pneumonia (VAP). The purpose of this study was to evaluate the effects of administration of a prebiotic, namely fenugreek seeds, on VAP prevention and clinical outcomes in critically ill patients. Methods: In this study, 60 mechanically ventilated patients were randomly divided into 2 groups (n=30 per group). Group 1 was given fenugreek seed powder by gavage, twice a day in addition to routine care, while group 2 received only routine care. Result: There was a significant reduction of patients diagnosed with VAP, as well as clostridium difficileassociated diarrhea and some complications of mechanical ventilation, in group 1 when compared to group 2. Improvement in VAP was significantly greater for group 1 as compared with group 2. Conclusion: The present study demonstrated that daily diet with fenugreek seeds can be used as an add-on therapy with other medications in prevention of VAP. The use of fenugreek seeds in the treatment plan of patients undergoing long-term intubation is recommended
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