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Exploring the therapeutic role of early heparin administration in ARDS management: a MIMIC-IV database analysis

Journal of intensive care, 2024-02, Vol.12 (1), p.9-9 [Peer Reviewed Journal]

2024. The Author(s). ;COPYRIGHT 2024 BioMed Central Ltd. ;2024. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;The Author(s) 2024 ;ISSN: 2052-0492 ;EISSN: 2052-0492 ;DOI: 10.1186/s40560-024-00723-5 ;PMID: 38409068

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  • Title:
    Exploring the therapeutic role of early heparin administration in ARDS management: a MIMIC-IV database analysis
  • Author: Xiao, Ling-Xi ; Zhu, De Liang ; Chen, Juan ; Lv, Jing ; Liu, Mei-Jun ; Dai, Xue ; Wang, Dao-Xin ; Deng, Wang
  • Subjects: Acute respiratory distress syndrome ; Analysis ; Anticoagulants ; Anticoagulants (Medicine) ; Blood pressure ; Chronic obstructive pulmonary disease ; Clinical outcomes ; Health aspects ; Heart rate ; Heparin ; Hospital patients ; Hypertension ; Inflammation ; Intensive care ; Intensive care units ; Medical research ; Medicine, Experimental ; MIMIC-IV database ; Mortality ; Patients ; Propensity score ; Renal replacement therapy ; Respiratory distress syndrome ; Thrombosis
  • Is Part Of: Journal of intensive care, 2024-02, Vol.12 (1), p.9-9
  • Description: Acute respiratory distress syndrome (ARDS) is a severe respiratory condition characterized by a high mortality rate, the management of which relies on supportive care and a profound understanding of its pathophysiology. Heparin, with its anticoagulant and potential anti-inflammatory properties, offers a new therapeutic opportunity for the treatment of ARDS. In this retrospective cohort study, we examined the MIMIC-IV database for ARDS patients who received prophylactic heparin within the first 72 h of ICU admission. Employing propensity score matching and inverse probability weighting (IPW) analysis, we evaluated the impact of early heparin use on patient outcomes, focusing on mortality rates. Patients who received prophylactic heparin had a significantly lower in-hospital mortality rate compared to those who did not (13.55% vs 17.93%, HR = 0.71, 95% CI: 0.54-0.93, P = 0.012). This result remained significant after propensity score matching (12.75% vs 17.93%, HR = 0.65, 95% CI 0.47-0.90, P = 0.010). Analysis using five different statistical models indicated that early use of heparin significantly reduced the in-hospital mortality rate, with HR = 0.669 (95% CI 0.487-0.919, P = 0.013) in the doubly robust model without balanced covariates; HR = 0.705 (95% CI 0.515-0.965, P = 0.029) with all covariates considered; HR = 0.660 (95% CI 0.491-0.888, P = 0.006) in the propensity score (IPW) model; HR = 0.650 (95% CI 0.470-0.900, P = 0.010) in the propensity score matching model; and HR = 0.706 (95% CI 0.536-0.930, P = 0.013) in the multivariate Cox regression model. Secondary outcomes indicated that heparin use was also associated with reduced mortality rates at 60 days, and 90 days. This research highlights that early prophylactic administration of heparin may substantially lower mortality in ARDS patients. These findings underscore the potential of heparin as a key component in the management of ARDS, offering a new perspective and novel strategies for clinical treatment.
  • Publisher: England: BioMed Central Ltd
  • Language: English
  • Identifier: ISSN: 2052-0492
    EISSN: 2052-0492
    DOI: 10.1186/s40560-024-00723-5
    PMID: 38409068
  • Source: PubMed Central
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