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

• Published in: Ain-Shams journal of anesthesiology 2013-04, Vol.6 (2), p.193-197
• Main Authors: Wadi, Sharif, Isawi, Baha, Ahmad, Sundus, Hasan, Mayar, Majdi, Hadil
• Format: Article
• Language: English
• Subjects: Heparin; Septic shock; Septicemia; Therapeutic use; Treatment; الأمراض; الأمراض المعدية; الدم
• ISSN: 1687-7934; 2090-925X

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 %), Po0.05]. The activated partial thromboplastin time throughout the course of the therapy showed comparable results in both groups (P40.05). Moreover, there was no significant difference in the rate of allogenic transfusion between the placebo group and the UFH group (P40.05). 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.