Is inhaled prophylactic heparin useful for prevention and Management of Pneumonia in ventilated ICU patients? : The IPHIVAP investigators of the Australian and New Zealand Intensive Care Society Clinical Trials Group
Copyright © 2016 Elsevier Inc. All rights reserved..
PURPOSE: To determine whether prophylactic inhaled heparin is effective for the prevention and treatment of pneumonia patients receiving mechanical ventilation (MV) in the intensive care unit.
METHODS: A phase 2, double blind randomized controlled trial stratified for study center and patient type (non-operative, post-operative) was conducted in three university-affiliated intensive care units. Patients aged ≥18years and requiring invasive MV for more than 48hours were randomized to usual care, nebulization of unfractionated sodium heparin (5000 units in 2mL) or placebo nebulization with 0.9% sodium chloride (2mL) four times daily with the main outcome measures of the development of ventilator associated pneumonia (VAP), ventilator associated complication (VAC) and sequential organ failure assessment scores in patients with pneumonia on admission or who developed VAP.
TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12612000038897.
RESULTS: Two hundred and fourteen patients were enrolled (72 usual care, 71 inhaled sodium heparin, 71 inhaled sodium chloride). There were no differences between treatment groups in terms of the development of VAP, using either Klompas criteria (6-7%, P=1.00) or clinical diagnosis (24-26%, P=0.85). There was no difference in the clinical consistency (P=0.70), number (P=0.28) or the total volume of secretions per day (P=.54). The presence of blood in secretions was significantly less in the usual care group (P=0.005).
CONCLUSION: Nebulized heparin cannot be recommended for prophylaxis against VAP or to hasten recovery from pneumonia in patients receiving MV.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2016 |
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| Erschienen: |
2016 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:34 |
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| Enthalten in: |
Journal of critical care - 34(2016) vom: 10. Aug., Seite 95-102 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bandeshe, Hiran [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 26.09.2017 Date Revised 02.12.2018 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jcrc.2016.04.005 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM261291939 |
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| 100 | 1 | |a Bandeshe, Hiran |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Is inhaled prophylactic heparin useful for prevention and Management of Pneumonia in ventilated ICU patients? |b The IPHIVAP investigators of the Australian and New Zealand Intensive Care Society Clinical Trials Group |
| 264 | 1 | |c 2016 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Completed 26.09.2017 | ||
| 500 | |a Date Revised 02.12.2018 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2016 Elsevier Inc. All rights reserved. | ||
| 520 | |a PURPOSE: To determine whether prophylactic inhaled heparin is effective for the prevention and treatment of pneumonia patients receiving mechanical ventilation (MV) in the intensive care unit | ||
| 520 | |a METHODS: A phase 2, double blind randomized controlled trial stratified for study center and patient type (non-operative, post-operative) was conducted in three university-affiliated intensive care units. Patients aged ≥18years and requiring invasive MV for more than 48hours were randomized to usual care, nebulization of unfractionated sodium heparin (5000 units in 2mL) or placebo nebulization with 0.9% sodium chloride (2mL) four times daily with the main outcome measures of the development of ventilator associated pneumonia (VAP), ventilator associated complication (VAC) and sequential organ failure assessment scores in patients with pneumonia on admission or who developed VAP | ||
| 520 | |a TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12612000038897 | ||
| 520 | |a RESULTS: Two hundred and fourteen patients were enrolled (72 usual care, 71 inhaled sodium heparin, 71 inhaled sodium chloride). There were no differences between treatment groups in terms of the development of VAP, using either Klompas criteria (6-7%, P=1.00) or clinical diagnosis (24-26%, P=0.85). There was no difference in the clinical consistency (P=0.70), number (P=0.28) or the total volume of secretions per day (P=.54). The presence of blood in secretions was significantly less in the usual care group (P=0.005) | ||
| 520 | |a CONCLUSION: Nebulized heparin cannot be recommended for prophylaxis against VAP or to hasten recovery from pneumonia in patients receiving MV | ||
| 650 | 4 | |a Clinical Trial, Phase II | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Nebulization | |
| 650 | 4 | |a Unfractionated heparin | |
| 650 | 4 | |a Ventilator associated complication | |
| 650 | 4 | |a Ventilator associated pneumonia | |
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| 700 | 1 | |a Dulhunty, Joel |e verfasserin |4 aut | |
| 700 | 1 | |a Dunlop, Rachael |e verfasserin |4 aut | |
| 700 | 1 | |a Holley, Anthony |e verfasserin |4 aut | |
| 700 | 1 | |a Jarrett, Paul |e verfasserin |4 aut | |
| 700 | 1 | |a Gomersall, Charles D |e verfasserin |4 aut | |
| 700 | 1 | |a Lipman, Jeff |e verfasserin |4 aut | |
| 700 | 1 | |a Lo, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a O'Donoghue, Steven |e verfasserin |4 aut | |
| 700 | 1 | |a Paratz, Jenny |e verfasserin |4 aut | |
| 700 | 1 | |a Paterson, David |e verfasserin |4 aut | |
| 700 | 1 | |a Roberts, Jason A |e verfasserin |4 aut | |
| 700 | 1 | |a Starr, Therese |e verfasserin |4 aut | |
| 700 | 1 | |a Stephens, Di |e verfasserin |4 aut | |
| 700 | 1 | |a Stuart, Janine |e verfasserin |4 aut | |
| 700 | 1 | |a Thomas, Jane |e verfasserin |4 aut | |
| 700 | 1 | |a Udy, Andrew |e verfasserin |4 aut | |
| 700 | 1 | |a White, Hayden |e verfasserin |4 aut | |
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