The Role of Synbiotics in Reducing Post-Operative Infections in Patients Undergoing Cardiac Surgery: A Pilot Study
Status:
Terminated
Trial end date:
2007-06-01
Target enrollment:
Participant gender:
Summary
All surgical procedures carry with them the risk of infection. Even a minor infection can
extend the hospitalization after cardiac surgery. The average minimum increase in length of
stay for a single infection is three days.
One of the many means used to reduce post-operative infections is the preventative, or
"prophylactic", administration of antibiotics just before and just after surgery. Because
antibiotics, and for that matter surgery itself, alter the body's natural immune and
inflammatory responses and the makeup of the bacteria in the intestine, there is a great deal
of scientific interest in using the supplementation of bacteria that naturally reside in the
intestine. It is felt that by doing so, the alterations in the immune response may be
corrected and the patient better able to fight infections. There are studies using probiotics
that have demonstrated a reduction in infection rates in patients undergoing abdominal
surgery.
Subjects will be patients at high risk for infection including those with any one or more of
the following characteristics: over 65 years old, poor heart function (ejection fraction
<40), diabetes (insulin dependant or non-insulin dependant), peripheral vascular disease,
kidney dysfunction (creatinine level >2mg/dl), obesity (body surface area > 2 m2), low serum
protein levels (albumin < 2.5 mg/dl), infection of the heart valve (endocarditis), or on any
antibiotics other than standard prophylaxis before surgery.
The safety of these products has been very well established.
Patients who consent to enter the study will receive the synbiotic mix, or a placebo, which
comes in a powder that may be mixed with a drink, or washed down into the stomach through the
NG tube if the patient is still on a ventilator. Dosing will be initiated within four hours
of patient arrival in the Cardiac Surgery Intensive Care Unit and will continue on a twice
daily basis for the duration of their admission days. Infection and diarrhea data will be
monitored.