Administration of nebulized heparin may reduce pulmonary inflammation and fibrin deposition in critically ill patients receiving mechanical ventilation, according to a new study published in the journal Critical Care.
Fifty patients expected to require mechanical ventilation for more than 48 hours were enrolled in the double-blind randomized placebo-controlled trial. Patients received nebulized heparin (25,000 U/5 ml) or placebo (normal saline) four or six hourly, depending on patient height. The study drug was continued while the patient remained ventilated to a maximum of 14 days from randomization.
The researchers found that nebulized heparin was not associated with a significant improvement in the primary end-point, the average daily partial pressure of oxygen to inspired fraction of oxygen ratio while mechanically ventilated, but was associated with improvement in the secondary end-point ventilator free days amongst survivors at day 28 (22.6 4.0 versus 18.0 7.1, treatment difference 4.6 days, 95% CI 0.9 to 8.3, P=0.02). The heparin administration was not associated with any increase in adverse events.
The researchers concluded that nebulized heparin was associated with fewer days of mechanical ventilation in critically ill patients expected to require prolonged mechanical ventilation.
Source: Critical Care