Treatment outcomes of infants with cyanotic congenital heart disease treated with synbiotics

• Published in: Pediatrics (Evanston) 2013-10, Vol.132 (4), p.e932-e938
• Main Authors: Dilli, Dilek, Aydin, Banu, Zenciroğlu, Ayşegül, Özyazici, Elif, Beken, Serdar, Okumuş, Nurullah
• Format: Article
• Language: English
• Subjects: Adult; Babies; Bacteria; Bifidobacterium - drug effects; Cardiovascular disease; Clinical trials; Congenital heart defects; Congenital heart disease; Cyanosis; Dosage and administration; Drug therapy; Enterocolitis, Necrotizing - drug therapy; Enterocolitis, Necrotizing - microbiology; Enterocolitis, Necrotizing - pathology; Female; Heart Defects, Congenital - diagnosis; Heart Defects, Congenital - diet therapy; Heart Defects, Congenital - epidemiology; Heart Defects, Congenital - pathology; Humans; Infant; Infant, Newborn; Male; Medical treatment; Nosocomial infections; Patient outcomes; Pediatrics; Probiotics; Prospective Studies; Sepsis; Sepsis - drug therapy; Sepsis - microbiology; Sepsis - pathology; Single-Blind Method; Synbiotics; Treatment Outcome
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2013-1262

The goal was to investigate the effect of orally administered synbiotics on outcome of infants with cyanotic congenital heart disease (CCHD). A prospective, blinded, randomized controlled trial was conducted to evaluate the effect of synbiotics on outcome of infants with CCHD. The infants with CCHD were assigned randomly to 2 groups. Infants in the study group were given synbiotic (Bifidobacterium lactis plus inulin) added to breast milk or mixed feeding until discharge or death. Infants in the placebo group were fed with breast milk or mixed feeding. The outcome measurements were nosocomial sepsis, necrotizing enterocolitis (NEC; Bell stage ≥ 2), length of NICU stay, and death. A total of 100 infants were enrolled in the trial: 50 in each arm. There were 9 cases of culture-proven sepsis (18%) in the placebo group and 2 cases (4%) in the synbiotic group (P = .03). Length of NICU stay did not differ between the groups (26 [14-36] vs 32 days [20-44], P = .07]. There were 5 cases of NEC (10%) in the placebo group and none in the synbiotic group (P = .03). The incidence of death was lower in synbiotic group (5 [10%] of 50 vs 14 [28.0%] of 50, respectively; P = .04). Synbiotics administered enterally to infants with CCHD might reduce the incidence of nosocomial sepsis, NEC, and death.