Does mechanical ventilation cause of small intesiınal bacteiıal overgrowth?

There may be many complications which can seriously affect morbidity and mortality during mechanical ventilation practice. One of them is the complications related to gastrointestinal system.In this study, we aimed to research the effects of mechanical ventilation practice upon intestinal flora. We planned to research the aerobic and anaerobic bacteria via culture method in the duodenal aspirate material taken endoscopically in patients that received MV in anesthesia critical care unite as study group (n=13) and patients not receiving MV in internal medicine unite as control group (n=14).Upper GIS endoscopy was performed at all patients after 48 hours of their hospitalization and the secretions of second dudenal part aspirated through sterile catheters. The cases who had antibiotic usage within last 2 weeks for any reason, gastrointestinal bleeding, mechanical or paralitic ileus, cardiovasculary instability as a contraindication for upper GIS endoscopy, suspicion of perforation were excluded from the study.Sterile fluid aspirate was delivered with sterile culture caps to the microbiology laboratory within 30 minutes under appropriate conditions. All aerobic and anaerobic cultures were incubated in 5-10% CO2 media at 350C . Aerobic cultures were reviewed after 24-48 hours of incubation periods, anaerobic cultures after 72 hours. The values of colonization of the cultures equal or higher than 105 cfu / ml were identified as Small intestinal bacterial overgrowth (SIBO).The study data were reviewed by SPSS for Windows 15.0, Man whitney u test, ki square analysis and Fisher?s exact test.Liver function tests were obtained high (p<0.05) and potassium levels near bottom level (p<0.05) in the findings. SIBO ratio was observed significantly low in oral-enteral feeding patients and significantly high in parenteral feeding but not oral-enteral feeding patients.SIBO ratio was found higher in MV group than C group (MV:69.2% and C:42.9%). Enteric bacteria ratio was found significantly high in MV group among each group of bacteria colonization (MV:46.2%, K : % 7.1% and p= 0.03).Decreased splancnic perfusion and hypomotility as a consequence of this hypoperfusion cause SIBO during mechanical ventilation. SIBO, as an important complication of MV, must be remembered during treatment period.Symptoms like chronic diarrhea, gase, flatulance, abdominal pain, nausea and weight loss may be developed especially because of enteric bacteria colonization in SIBO. This clinical manifestation is a candidate of becoming important in critical care patients receiving MV support.