Nebulized Heparin in Burn Patients with Inhalation Trauma-Safety and Feasibility

Area of Science:

• Critical Care Medicine
• Pulmonary Medicine
• Trauma Surgery

Background:

• Pulmonary hypercoagulopathy is a known complication of inhalation trauma.
• Nebulized heparin is a potential treatment for inhalation injury, but evidence is conflicting.
• This study investigated the safety and feasibility of nebulized heparin in this patient population.

Purpose of the Study:

• To evaluate the safety and feasibility of nebulized unfractionated heparin in adult patients with inhalation trauma.
• To assess secondary outcomes related to safety and feasibility of the treatment.
• To determine if nebulized heparin is a viable therapeutic option for inhalation injury.

Main Methods:

• A multicenter, double-blind, placebo-controlled randomized trial was conducted.
• Adult patients with inhalation trauma received nebulized unfractionated heparin or placebo every four hours for 14 days.
• The study focused on secondary outcomes of safety and feasibility due to premature termination.

Main Results:

• The trial was stopped early due to low recruitment and high costs.
• Serious respiratory issues, including expiratory filter saturation, occurred with nebulized heparin.
• Nebulizations were frequently withheld in the heparin group due to respiratory complications and bleeding risks.

Conclusions:

• Frequent nebulizations of heparin in burn patients with inhalation trauma present significant safety and feasibility challenges.
• These findings suggest caution when considering nebulized heparin for this patient group.
• Further research is needed to address the identified safety concerns before widespread adoption.