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Nebulized Heparin to Reduce COVID-19-induced Acute Lung Injury: A Prospective Observational Study
Bhavna Gupta1, Saurabh Chandrakar1, Nidhi Gupta1
1Department of Anaesthesia and Critical Care, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Summary
Nebulized heparin improved oxygenation in COVID-19 patients with acute respiratory distress syndrome (ARDS). While it did not significantly alter inflammatory markers or D-dimer levels, this treatment shows promise for reducing lung injury severity.
Area of Science:
- Critical Care Medicine
- Pulmonology
- Pharmacology
Background:
- COVID-19 associated high mortality is linked to complications like disseminated intravascular coagulation (DIC) and venous thromboembolism.
- Heparin has been explored as a potential treatment, but its efficacy in mitigating COVID-19 related lung injury requires further validation.
Purpose of the Study:
- To investigate the role of nebulized heparin in reducing the severity of COVID-19-induced lung injury.
- To assess the impact of nebulized heparin on oxygenation and inflammatory markers in patients with COVID-19 acute respiratory distress syndrome (ARDS).
Main Methods:
- A prospective observational study involving 30 patients with COVID-19 ARDS admitted to the ICU.
- Patients received nebulized unfractionated heparin (5,000 units/mL) every 6 hours for 7 days.
- Primary outcome: Improvement in oxygenation (PaO2/FiO2 ratio). Secondary outcomes: Changes in inflammatory markers (NLR, IL-6, D-dimer), mechanical ventilation duration, and hospital stay.
Main Results:
- A statistically significant improvement in oxygenation (PaO2/FiO2 ratio) was observed over the 7-day treatment period (p=0.00).
- Significant improvements in PaO2 and SO2 levels were noted.
- No statistically significant changes were found in neutrophil-lymphocyte ratio, IL-6 levels, or D-dimer values.
Conclusions:
- Nebulized heparin administration in COVID-19 pneumonia with mild ARDS may enhance oxygenation.
- The study suggests potential benefits in improving inflammatory markers, though with variable sensitivity and specificity.
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