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

作　　者：Xiaodong Lan Zhiyong Huang Ziming Tan Zhenjia Huang Dehuai Wang Yuesheng Huang 

机构地区：[1]Department of burn and plastic surgery,Chengdu Second People’s Hospital,Chengdu,610021,China [2]Department of Wound Repair,Institute of Wound Repair,Shenzhen People’s Hospital,the First Affiliated Hospital of South University of Science and Technology,and the Second Clinical Medical College of Jinan University,Shenzhen,518020,China

出　　处：《Burns & Trauma》2020年第1期293-302,共10页烧伤与创伤（英文）

摘　　要：Background:Smoke 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.Methods:A 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.Results:Nine 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 heparintreated 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).

关 键 词：BURNS Inhalation injury HEPARIN Systematic review 

分 类 号：R73[医药卫生—肿瘤]