Trial reportCritical care (London, England)2010
Nebulized heparin is associated with fewer days of mechanical ventilation in critically ill patients: a randomized controlled trial.
Trial report in Critical care (London, England), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 53 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Nebulized Heparin vs. Placebo for the Treatment of COVID-19 Induced Lung Injury
Dynamics of Hemostatic Parameters in COVID-19 and Comparison of Intervention Strategies Through Adaptive Clinical Trial
Efficacy and Safety Study to Evaluate the Use of Nebulized Heparin in Patients With Severe Acute Respiratory Syndrome Covid-19 (SARS-CoV-2)
INHALEd Unfractionated HEParin for the Treatment of Hospitalized Patients With COVID-19 Pneumonia
Who cites it
53 citing papers in PubMed, 4 syntheses or guidelines pooled it, 99 citations in OpenAlex.
- The effect of nebulized heparin on clinical outcomes in mechanically ventilated patients: a meta-analysis and review of the literature.The Journal of international medical research · 2023Pooled it
- Heterogeneity of surrogate outcome measures used in critical care studies: A systematic review.Clinical trials (London, England) · 2023Pooled it
- Mucoactive agents for acute respiratory failure in the critically ill: a systematic review and meta-analysis.Thorax · 2020Pooled it
- Nebulized anticoagulants for acute lung injury - a systematic review of preclinical and clinical investigations.Critical care (London, England) · 2012Pooled it
- Nebulised heparin for patients with or at risk of acute respiratory distress syndrome: a multicentre, randomised, double-blind, placebo-controlled phase 3 trial.The Lancet. Respiratory medicine · 2021Trial
- Nebulized heparin and salbutamol versus salbutamol alone in acute exacerbations of chronic obstructive pulmonary disease requiring mechanical ventilation: a double-blind randomized controlled trial.Korean journal of anesthesiology · 2020Trial
- Trial
- Review
- Scheduled Bronchoscopy with Nebulized Heparin and N-Acetylcysteine in Burn Patients with Inhalation Injury: A Randomized Trial.European burn journal · 2026Article
- One syndrome, many diseases: toward precision pharmacotherapy in acute respiratory distress syndrome.Frontiers in pharmacology · 2026Review
- Circulating and Respiratory Biomarkers in Sepsis-Induced ARDS: Diagnostic and Prognostic Insights - A Narrative Review.Journal of inflammation research · 2026Review
- Efficacy of inhaled nebulised unfractionated heparin to prevent intubation or death in hospitalised patients with COVID-19: an investigator-initiated international meta-trial of randomised clinical studies.EClinicalMedicine · 2025Article
- Physiology and pathophysiology of mucus and mucolytic use in critically ill patients.Critical care (London, England) · 2025Review
- Can nebulised heparin reduce acute lung injury in patients with SARS‑CoV‑2 requiring advanced respiratory support in Ireland: the CHARTER‑Ireland phase Ib/IIa, randomised, parallel-group, open-label study.Intensive care medicine experimental · 2025Article
- Article
- Heparin, Low Molecular Weight Heparin, and Non-Anticoagulant Derivatives for the Treatment of Inflammatory Lung Disease.Pharmaceuticals (Basel, Switzerland) · 2023Review
- Can nebulised HepArin Reduce morTality and time to Extubation in patients with COVID-19 Requiring invasive ventilation Meta-Trial (CHARTER-MT): Protocol and statistical analysis plan for an investigator-initiated international meta-trial of prospective randomised clinical studies.British journal of clinical pharmacology · 2022Article
- Anticoagulant Treatment in Severe ARDS COVID-19 Patients.Journal of clinical medicine · 2022Review
- Anticoagulation as a therapeutic strategy for hospitalised patients with COVID-19.Thrombosis update · 2022Article
- The Association of Low Molecular Weight Heparin Use and In-hospital Mortality Among Patients Hospitalized with COVID-19.Cardiovascular drugs and therapy · 2022Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionProlonged mechanical ventilation has the potential to aggravate or initiate pulmonary inflammation and cause lung damage through fibrin deposition. Heparin may reduce pulmonary inflammation and fibrin deposition. We therefore assessed whether nebulized heparin improved lung function in patients expected to require prolonged mechanical ventilation.
methodsFifty patients expected to require mechanical ventilation for more than 48 hours were enrolled in a double-blind randomized placebo-controlled trial of nebulized heparin (25,000 U) or placebo (normal saline) 4 or 6 hourly, depending on patient height. The study drug was continued while the patient remained ventilated to a maximum of 14 days from randomization.
resultsNebulized heparin was not associated with a significant improvement in the primary end-point, the average daily partial pressure of oxygen to inspired fraction of oxygen ratio while mechanically ventilated, but was associated with improvement in the secondary end-point, ventilator-free days amongst survivors at day 28 (22.6 ± 4.0 versus 18.0 ± 7.1, treatment difference 4.6 days, 95% CI 0.9 to 8.3, P = 0.02). Heparin administration was not associated with any increase in adverse events.
conclusionsNebulized heparin was associated with fewer days of mechanical ventilation in critically ill patients expected to require prolonged mechanical ventilation. Further trials are required to confirm these findings.
trial registrationThe Australian Clinical Trials Registry (ACTR-12608000121369).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.