Nebulized heparin for inhalation injury in burn patients: a systematic review and meta-analysis

Xiaodong Lan; Zhiyong Huang; Ziming Tan; Zhenjia Huang; Dehuai Wang; Yuesheng Huang

doi:10.1093/burnst/tkaa015

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Nebulized heparin for inhalation injury in burn patients: a systematic review and meta-analysis

更新时间：2022-06-09

- Nebulized heparin for inhalation injury in burn patients: a systematic review and meta-analysis
- Burns & Trauma Vol. 8, Issue 1, (2020)
- 作者机构：
  
  1. Department of burn and plastic surgery
  2. Department of Wound Repair
- 作者简介：
- 基金信息：
- DOI：10.1093/burnst/tkaa015
  CLC：
- Published：2020，
  
  Published Online：4 June 2020，
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Xiaodong Lan, Zhiyong Huang, Ziming Tan, Zhenjia Huang, Dehuai Wang, Yuesheng Huang, Nebulized heparin for inhalation injury in burn patients: a systematic review and meta-analysis, Burns & Trauma, Volume 8, 2020, tkaa015, https://doi.org/10.1093/burnst/tkaa015
DOI：

Xiaodong Lan, Zhiyong Huang, Ziming Tan, Zhenjia Huang, Dehuai Wang, Yuesheng Huang, Nebulized heparin for inhalation injury in burn patients: a systematic review and meta-analysis, Burns & Trauma, Volume 8, 2020, tkaa015, https://doi.org/10.1093/burnst/tkaa015 DOI：

摘要

Abstract

BackgroundSmoke inhalation injury increases overall burn mortality. Locally applied heparin attenuates lung injury in burn animal models of smoke inhalation. It is uncertain whether local treatment of heparin is benefit for burn patients with inhalation trauma. We systematically reviewed published clinical trial data to evaluate the effectiveness of nebulized heparin in treating burn patients with inhalation injury.MethodsA systematic search was undertaken in PubMed

the Cochrane Library

Embase

Web of Science

the Chinese Journals Full-text Database

the China Biomedical Literature Database and the Wanfang Database to obtain clinical controlled trails evaluating nebulized heparin in the treatment of burn patients with inhalation injury. Patient and clinical characteristics

interventions and physiological and clinical outcomes were recorded. Cochrane Risk of Bias Evaluation Tool and the Newcastle–Ottawa Scale were used to evaluate data quality. Potential publication bias was assessed by Egger’s test. A sensitivity analysis was conducted to assess the stability of the results. The meta-analysis was conducted in R 3.5.1 software.ResultsNine trials were eligible for the systematic review and meta-analysis. Nebulized heparin can reduce lung injury and improve lung function in burn patients with inhalation injury without abnormal coagulation or bleeding

but the findings are still controversial. Mortality in the heparin-treated group was lower than that of the traditional treatment group (relative risk (RR) 0.75). The duration of mechanical ventilation (DOMV) was shorter in the heparin-treated group compared to the traditional treatment group (standardized mean difference (SMD) −0.78). Length of hospital stay was significantly shorter than that in the traditional treatment group (SMD −0.42)

but incidence rates of pneumonia and unplanned reintubation were not significantly different in the study groups (RRs 0.97 and 0.88

respectively). No statistically significant publication biases were detected for the above clinical endpoints (p > 0.05).ConclusionsBased on conventional aerosol therapy

heparin nebulization can further reduce lung injury

improve lung function

shorten DOMV and length of hospital stay

and reduce mortality

although it does not reduce the incidence of pneumonia and/or the unplanned reintubation rate.

关键词

Keywords

BurnsInhalation injuryHeparinSystematic review

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