Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/10359
Title: 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.
Authors: Bandeshe, Hiran
Boots, Rob
Dulhunty, Joel
Dunlop, Rachael
Holley, Anthony
Jarrett, Paul
Gomersall, Charles D
Lipman, Jeff
Lo, Thomas
O'Donoghue, Steven
Paratz, Jenny
Paterson, David
Roberts, Jason A
Starr, Therese
Stephens, Di
Stuart, Janine
Thomas, Jane
Udy, Andrew
White, Hayden
Affiliation: Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia; Burns Trauma and Critical Care Research Centre, University of Queensland, QLD, Australia..
Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia; Burns Trauma and Critical Care Research Centre, University of Queensland, QLD, Australia. Electronic address: r.boots@uq.edu.au..
Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia; Burns Trauma and Critical Care Research Centre, University of Queensland, QLD, Australia..
Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia; Burns Trauma and Critical Care Research Centre, University of Queensland, QLD, Australia..
Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia; Burns Trauma and Critical Care Research Centre, University of Queensland, QLD, Australia..
Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia; Burns Trauma and Critical Care Research Centre, University of Queensland, QLD, Australia..
Prince of Wales Hospital, Chinese University of Hong Kong, Sha Tin, Hong Kong..
Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia; Burns Trauma and Critical Care Research Centre, University of Queensland, QLD, Australia..
Prince of Wales Hospital, Chinese University of Hong Kong, Sha Tin, Hong Kong..
Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia; Burns Trauma and Critical Care Research Centre, University of Queensland, QLD, Australia..
Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia; Burns Trauma and Critical Care Research Centre, University of Queensland, QLD, Australia; Heart Foundation Research Centre, Griffith University..
Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia; Burns Trauma and Critical Care Research Centre, University of Queensland, QLD, Australia..
Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia; Burns Trauma and Critical Care Research Centre, University of Queensland, QLD, Australia..
Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia; Burns Trauma and Critical Care Research Centre, University of Queensland, QLD, Australia..
Intensive Care Unit. Royal Darwin Hospital, NT, Australia..
Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia; Burns Trauma and Critical Care Research Centre, University of Queensland, QLD, Australia..
Intensive Care Unit. Royal Darwin Hospital, NT, Australia..
Department of Intensive Care and Hyperbaric Medicine, The Alfred, Prahran, Victoria, Australia..
Intensive Care Unit. Logan Hospital, Queensland, Australia..
Issue Date: 2016
Citation: Journal of critical care 2016; 34: 95-102
Abstract: 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. 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. Australian and New Zealand Clinical Trials Registry ACTRN12612000038897. 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). Nebulized heparin cannot be recommended for prophylaxis against VAP or to hasten recovery from pneumonia in patients receiving MV.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/10359
DOI: 10.1016/j.jcrc.2016.04.005
Type: Clinical Trial, Phase II
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Subjects: Nebulization
Unfractionated heparin
Ventilator associated complication
Ventilator associated pneumonia
Administration, Inhalation
Adolescent
Adult
Aged
Aged, 80 and over
Australia
Double-Blind Method
Female
Fibrinolytic Agents
Heparin
Humans
Intensive Care Units
Male
Middle Aged
Nebulizers and Vaporizers
New Zealand
Pneumonia, Ventilator-Associated
Respiration, Artificial
Young Adult
Appears in Collections:NT Health digital library

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