Painful burns in children are gut-wrenching, in more ways than one.
As the third leading cause of death in children behind car accidents and drowning, burns can devastate the gut microflora which may lead to sepsis and organ failure. Enhancing immunity and preventing bacterial invasion from the gut has been a goal. Tube feedings enriched with glutamine and omega-3 fatty acids can reduce wound infection rates and length of hospital stay in critically ill patients.
Evidence for studying probiotics in burn patients
- Probiotics maintain gut function, compete against pathogens and produce substances called bacteriocins which inhibit pathogens.
- One example, lactic acid bacteria (LAB) can improve the innate immune system.
- Probiotics improved the gut barrier in animal burn models.
Could probiotics improve outcomes in children?
A two-year study was done recently to evaluate the effect of probiotic supplementation on pediatric post-burn patients who were admitted to Tanta University Hospital in Egypt between May 2014 and May 2016. The study was published in Annals of Burns and Fire Disasters.
- Forty thermally-injured pediatric (ages 1-14) patients with total body surface burns between 20-50% and depth between 5-10% were randomized in a prospective, double-blind, controlled clinical trial into two even groups:
- Probiotic group (n=20), who received probiotic preparations
- Placebo control group (n=20).
Clinical outcomes including incidence of infection, need for grafting, length of hospital stay and mortality were recorded.
Results in probiotic vs. placebo group:
- Frequency of diarrhea (3 vs. 9)
- Need for grafting (2 vs. 8)
- Length of hospital stay (17.25 ± 0.5 days vs. 21.9 ± 2.2 days)
- A trend towards a decrease in incidence of infections (7 vs. 12) was noted in the probiotic group.
Those children in the probiotic group showed significant improvement related to wound healing and length of hospital stay. Still unclear is probiotics’ effect on infectious morbidity and mortality.
But any relief offered would be welcomed for these suffering children.