CoChat
Sign Up
Cited by 78Nosocomial Infections in ICUSepsis Diagnosis and TreatmentClinical Nutrition and Gastroenterology

Impact of selective decontamination of the digestive tract on multiple organ dysfunction syndrome: systematic review of randomized controlled trials

Silvestri, Luciano, van Saene, Hendrick K. F., Zandstra, Durk F., Marshall, John C., Gregori, Dario, Gullo, Antonino·2010·Critical Care Medicine
DOI 10.1097/ccm.0b013e3181d9db8c
Open this paper in CoChat — free account

Abstract

OBJECTIVE: We examined the impact of selective decontamination of the digestive tract on multiple organ dysfunction syndrome. DATA SOURCES: We searched MEDLINE, EMBASE, the Cochrane Register of Controlled Trials, previous meta-analyses, and meetings proceedings. STUDY SELECTION: We included all randomized trials comparing both oropharyngeal and intestinal administration of antibiotics in selective decontamination of the digestive tract with or without a parenteral component, with placebo or standard therapy used in the controls. DATA EXTRACTION: Two reviewers independently applied selection criteria, performed quality assessment, and extracted the data. The primary end point was the number of patients with multiple organ dysfunction syndrome developing during intensive care unit stay. Secondary end points were overall mortality and multiple organ dysfunction syndrome-related mortality. Odds ratios were pooled with the random effect model. DATA SYNTHESIS: We identified seven randomized trials including 1270 patients. Multiple organ dysfunction syndrome was found in 132 of 637 patients (20.7%) in the selective decontamination of the digestive tract group and in 219 of 633 patients (34.6%) in the control group (odds ratio, 0.50; 95% confidence interval, 0.34-0.74; p < .001). Overall mortality for selective decontamination of the digestive tract vs. control patients was 119 of 637 (18.7%) and 145 of 633 (22.9%), respectively, demonstrating a nonsignificant reduction in the odds of death (odds ratio, 0.82; 95% confidence interval, 0.51-1.32; p = .41). In five studies including 472 patients, multiple organ dysfunction syndrome-related mortality was demonstrated in 31 of 239 (13%) patients in selective decontamination of the digestive tract group and 37 of 233 (15.9%) in the controls (odds ratio, 0.84; 95% confidence interval, 0.48-1.41; p = .54). CONCLUSIONS: Selective decontamination of the digestive tract reduces the number of patients with multiple organ dysfunction syndrome. Mortality was not significantly reduced, probably because of the small sample size.

Integrity signals

Registry

Crossref · 10.1097/ccm.0b013e3181d9db8c

Cites

52 of 52 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Patients who receive selective decontamination of the digestive tract are less likely to develop multiorgan failure or die than patients who do not.

    “patients who receive SDD are less likely to develop multiorgan failure91 or die96 than patients who do not”

    From The microbiome and critical illness (2016) · cites this paper as [91]

  • Selective decontamination of the digestive tract is the most thoroughly studied intervention in critical care research and has unambiguous benefits in the prevention of infections, multiorgan failure, and death.

    “SDD is the most thoroughly studied intervention in critical care research, and has unambiguous benefits in the prevention of infections, multiorgan failure, and death.”

    From The microbiome and critical illness (2016) · cites this paper as [91]

Cites

Flagged first, then by citations

1 of the 53 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Silvestri, L., van Saene, H. K. F., Zandstra, D. F., Marshall, J. C., Gregori, D., & Gullo, A.
Affiliations
Presidio Ospedaliero (IT)
Venue
Critical Care Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2010-05
Volume
38
Issue
5
Pages
1370-1376
ISSN
0090-3493 (ISSN-L)
DOI
10.1097/ccm.0b013e3181d9db8c
OpenAlex
W2082604404
Cited by
78
References
53
Citations by year
2026: 2 · 2025: 2 · 2024: 2 · 2023: 5 · 2022: 7 · 2021: 4 · 2020: 7 · 2019: 2 · 2018: 6 · 2017: 4 · 2016: 4 · 2015: 3 · 2014: 4 · 2013: 2 · 2012: 10
FWCI
1.20
Type
journal article
Language
en
Open access
closed
Locations
  • Critical Care Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Padua Research Archive (University of Padova) (submittedVersion)
Topics
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
Keywords
selective decontamination of the digestive tract, multiple organ failure, antibiotics, intensive care unit, mortality, sepsis, critically ill patients
MeSH terms
Anti-Bacterial Agents, Gram-Negative Aerobic Bacteria, Humans, Multiple Organ Failure, Randomized Controlled Trials as Topic, Gastrointestinal Tract

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review