| Title |
Nebulized heparin for patients under mechanical ventilation: an individual patient data meta-analysis
|
|---|---|
| Published in |
Annals of Intensive Care, April 2016
|
| DOI | 10.1186/s13613-016-0138-4 |
| Pubmed ID | |
| Authors |
Gerie J. Glas, Ary Serpa Neto, Janneke Horn, Amalia Cochran, Barry Dixon, Elamin M. Elamin, Iris Faraklas, Sharmila Dissanaike, Andrew C. Miller, Marcus J. Schultz |
| Abstract |
Pulmonary coagulopathy is a characteristic feature of lung injury including ventilator-induced lung injury. The aim of this individual patient data meta-analysis is to assess the effects of nebulized anticoagulants on outcome of ventilated intensive care unit (ICU) patients. A systematic search of PubMed (1966-2014), Scopus, EMBASE, and Web of Science was conducted to identify relevant publications. Studies evaluating nebulization of anticoagulants in ventilated patients were screened for inclusion, and corresponding authors of included studies were contacted to provide individual patient data. The primary endpoint was the number of ventilator-free days and alive at day 28. Secondary endpoints included hospital mortality, ICU- and hospital-free days at day 28, and lung injury scores at day seven. We constructed a propensity score-matched cohort for comparisons between patients treated with nebulized anticoagulants and controls. Data from five studies (one randomized controlled trial, one open label study, and three studies using historical controls) were included in the meta-analysis, compassing 286 patients. In all studies unfractionated heparin was used as anticoagulant. The number of ventilator-free days and alive at day 28 was higher in patients treated with nebulized heparin compared to patients in the control group (14 [IQR 0-23] vs. 6 [IQR 0-22]), though the difference did not reach statistical significance (P = 0.459). The number of ICU-free days and alive at day 28 was significantly higher, and the lung injury scores at day seven were significantly lower in patients treated with nebulized heparin. In the propensity score-matched analysis, there were no differences in any of the endpoints. This individual patient data meta-analysis provides no convincing evidence for benefit of heparin nebulization in intubated and ventilated ICU patients. The small patient numbers and methodological shortcomings of included studies underline the need for high-quality well-powered randomized controlled trials. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 1 | 33% |
| Unknown | 2 | 67% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Practitioners (doctors, other healthcare professionals) | 2 | 67% |
| Members of the public | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 42 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 42 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 6 | 14% |
| Student > Master | 6 | 14% |
| Student > Postgraduate | 4 | 10% |
| Student > Doctoral Student | 3 | 7% |
| Professor > Associate Professor | 3 | 7% |
| Other | 8 | 19% |
| Unknown | 12 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 15 | 36% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 5% |
| Biochemistry, Genetics and Molecular Biology | 2 | 5% |
| Agricultural and Biological Sciences | 2 | 5% |
| Business, Management and Accounting | 1 | 2% |
| Other | 5 | 12% |
| Unknown | 15 | 36% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 August 2020.
All research outputs
#14,587,003
of 24,475,473 outputs
Outputs from Annals of Intensive Care
#783
of 1,123 outputs
Outputs of similar age
#137,566
of 274,775 outputs
Outputs of similar age from Annals of Intensive Care
#15
of 29 outputs
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