Effect of Nebulized Heparin on Mechanically Ventilated Patients

Abstract

Background: Previous clinical studies have shown that nebulized heparin can shorten the duration of mechanical ventilation in people with acute respiratory distress syndrome (ARDS). The current study examines whether nebulization with heparin provides similar benefits compared to normal saline. Method: A six-month randomized controlled trial was conducted in a tertiary care hospital. The study included patients who were intubated during their stay in the intensive care unit (ICU) and required mechanical ventilation for more than 48 hours. Both groups of patients had a PaO2/FiO2 ratio of less than 300. Enrolled patients were randomly assigned to two groups using a lottery method: Group A received nebulized heparin, while Group B received nebulized normal saline. The researchers measured the PaO2/FiO2 ratio in both groups at baseline, day 3 and day 7. They also recorded the number of days without ventilator support and mortality during the first 28 days for both groups. Results: A total of 108 subjects between the ages of 18 and 60 years, regardless of gender, admitted to the intensive care unit (ICU) and requiring mechanical ventilation were included in the study. The results of our study showed that in group A the mean PaO2/FiO2 ratio was 222.7 ± 65.51 standard deviation (SD), while in group B on the third day it was 200.6 ± 60.8 SD (p = 0, 07). On day 7, the mean PaO2/FiO2 ratio was 227.4-218.3 SD in group B and 218.3-49.1 SD in group A (p=0.41). In terms of ventilator-free days, the mean duration (composite) was 16.9 x 9.1 standard deviations in group A and 12.6 x 7.9 standard deviations in group B for the 28-day period (p=0.01) . Conclusions: No significant differences in the mean PaO2/FiO2 ratio between the two groups on day 3 and day 7 were observed. However, looking at both survivors and non-survivors, as well as survivors alone, patients who received aerosolized heparin had significantly more ventilation-free days compared to those who received placebo. No significant differences were found between the two groups in terms of mortality over the 28-day period.