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Low-dose heparin as treatment for early disseminated intravascular coagulation during sepsis: A prospective clinical study

机译:低剂量肝素治疗败血症早期弥散性血管内凝血的前瞻性临床研究

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摘要

The present study aimed to investigate whether low-dose heparin improves the condition of patients suffering from early disseminated intravascular coagulation (pre-DIC) during sepsis. In total, 37 patients were randomly divided into low-dose heparin intervention and control groups. The heparin group received a low-dose of heparin for 5–7 days, while the other group received only saline. The two groups were treated for sepsis. Blood samples were collected at various times and acute physiology and chronic health evaluation (APACHE)-II scores were recorded at day 1 and 7. In addition, the number of days applying mechanical ventilation and in the intensive care unit (ICU) were recorded, as well as the 28-day mortality rate. APACHE-II scores in the two groups decreased following treatment, however, scores in the heparin group decreased more significantly. Prothrombin fragment and thrombin-antithrombin complex levels in the heparin group were significantly decreased. In addition, the number of days applying a ventilator was fewer and the total stay in ICU was significantly shorter compared with the control group. Significantly fewer complications were observed in the heparin group, however, there was no significant difference in the 28-day mortality rate. In conclusion, low-dose heparin improves the hypercoagulable state of sepsis, which subsequently reduces the incidence of DIC or multiple organ dysfunction syndrome, decreasing the number of days of mechanical ventilation and hospitalization.
机译:本研究旨在调查低剂量肝素是否能改善败血症期间早期弥散性血管内凝血(pre-DIC)患者的病情。共有37例患者随机分为低剂量肝素干预组和对照组。肝素组接受低剂量肝素治疗5-7天,而另一组仅接受生理盐水。两组接受败血症治疗。在不同时间采集血样,并在第1天和第7天记录急性生理和慢性健康评估(APACHE)-II得分。此外,记录进行机械通气和重症监护病房(ICU)的天数,以及28天的死亡率。两组的APACHE-II分数在治疗后下降,但是,肝素组的分数下降更为明显。肝素组的凝血酶原片段和凝血酶-抗凝血酶复合物水平显着降低。此外,与对照组相比,使用呼吸机的天数更少,并且在ICU的总停留时间明显缩短。肝素组的并发症明显减少,但是28天死亡率没有显着差异。总之,低剂量肝素改善脓毒症的高凝状态,从而降低DIC或多器官功能障碍综合征的发生率,减少机械通气和住院天数。

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