ORIGINAL ARTICLE
Year : 2013  |  Volume : 6  |  Issue : 2  |  Page : 193-197

Comparative, double-blind, retrospective study for the role of heparin in septic shock


Department of Anesthesia and Intensive Care, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Correspondence Address:
Hadil Magdi
Department of Anesthesia and Intensive Care, Faculty of Medicine, Ain Shams University, 116 Rue el Hegaz, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.7123/01.ASJA.0000428294.75130.66

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Background

Sepsis and septic shock represent a systemic inflammatory state with considerable procoagulant elements. Unfractionated heparin (UFH) is a known anticoagulant, which also has anti-inflammatory properties.

Objective

To evaluate the impact of an intravenous low dose of UFH in a cohort of patients diagnosed with septic shock.

Design

Retrospective, propensity matched, cohort study.

Setting

Ain Shams hospitals ICU units.

Patients

One hundred and forty-six of 270 patients diagnosed with septic shock.

Intervention

Patients were assigned randomly to receive placebo or a low dose of UFH 500 IU/h for 7 days after ICU admission.

Measurement and main results

The primary outcome was the effect of UFH on mortality over 28 days and the secondary outcome was the safety of heparin assessed by comparing the activated partial thromboplastin time values and the need for allogenic transfusion. The systemic administration of low-dose UFH in septic shock is associated with a decrease in mortality over the 28 days [eight of 60 (13%) vs. 18 of 64 (28%), P<0.05]. The activated partial thromboplastin time throughout the course of the therapy showed comparable results in both groups (P>0.05). Moreover, there was no significant difference in the rate of allogenic transfusion between the placebo group and the UFH group (P>0.05).

Conclusion

Early administration of intravenous low-dose UFH may be associated with a decrease in 28-day mortality when administered to patients diagnosed with septic shock.



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