ReviewAnnals of translational medicine2017
Nebulized anticoagulants in lung injury in critically ill patients-an updated systematic review of preclinical and clinical studies.
Review in Annals of translational medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04466670 (Dynamics of Hemostatic Parameters in COVID-19 and Comparison of Intervention Strategies Through Adaptive Clinical Trial), which is not on this map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Dynamics of Hemostatic Parameters in COVID-19 and Comparison of Intervention Strategies Through Adaptive Clinical Trial
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 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
- Inhaled Heparin to Shorten Antibiotic Duration in Ventilator-Associated Pneumonia: A Randomized Double-Blind Controlled Trial.Health science reports · 2026Article
- Inhaled nebulised medications in palliative care - a survey among palliative care practitioners in Germany.BMC palliative care · 2025Article
- Exploring the therapeutic role of early heparin administration in ARDS management: a MIMIC-IV database analysis.Journal of intensive care · 2024Article
- Heparin, Heparan Sulphate and Sepsis: Potential New Options for Treatment.Pharmaceuticals (Basel, Switzerland) · 2023Review
- Case series of nebulizing r-tPA for COVID-19 induced acute respiratory distress syndrome.Clinical case reports · 2022Article
- Nebulized Non-Immunogenic Staphylokinase in the Mice Acute Lung Injury Model.International journal of molecular sciences · 2022Article
- Inhalational injury and use of heparin & N-acetylcysteine nebulization: A case report.Respiratory medicine case reports · 2022Article
- Comparison of direct and indirect models of early induced acute lung injury.Intensive care medicine experimental · 2020Article
- Alkaline phosphatase in pulmonary inflammation-a translational study in ventilated critically ill patients and rats.Intensive care medicine experimental · 2020Article
- Transesophageal echocardiography-associated tracheal microaspiration and ventilator-associated pneumonia in intubated critically ill patients: a multicenter prospective observational study.Critical care (London, England) · 2020Observational
- Inhaled and systemic heparin as a repurposed direct antiviral drug for prevention and treatment of COVID-19.Clinical medicine (London, England) · 2020Article
- The Potential Role of Coagulation Factor Xa in the Pathophysiology of COVID-19: A Role for Anticoagulants as Multimodal Therapeutic Agents.TH open : companion journal to thrombosis and haemostasis · 2020Review
- SARS-2 Coronavirus-Associated Hemostatic Lung Abnormality in COVID-19: Is It Pulmonary Thrombosis or Pulmonary Embolism?Seminars in thrombosis and hemostasis · 2020Review
- Nebulised heparin as a treatment for COVID-19: scientific rationale and a call for randomised evidence.Critical care (London, England) · 2020Review
- Fibrinolytic abnormalities in acute respiratory distress syndrome (ARDS) and versatility of thrombolytic drugs to treat COVID-19.Journal of thrombosis and haemostasis : JTH · 2020Review
- Pharmacological Agents Targeting Thromboinflammation in COVID-19: Review and Implications for Future Research.Thrombosis and haemostasis · 2020Review
- Future Trends in Nebulized Therapies for Pulmonary Disease.Journal of personalized medicine · 2020Review
- Effects of nebulized antithrombin and heparin on inflammatory and coagulation alterations in an acute lung injury model in rats.Journal of thrombosis and haemostasis : JTH · 2020Article
- Glycosaminoglycans as Multifunctional Anti-Elastase and Anti-Inflammatory Drugs in Cystic Fibrosis Lung Disease.Frontiers in pharmacology · 2020Review
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 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Pneumonia, inhalation trauma and acute respiratory distress syndrome (ARDS), typical causes of lung injury in critically ill patients, are all three characterized by dysregulated inflammation and coagulation in the lungs. Nebulized anticoagulants are thought to have beneficial effects as they could attenuate pulmonary coagulopathy and maybe even affect pulmonary inflammation. A systematic search of the medical literature was performed using terms referring to aspects of the condition ('pneumonia', 'inhalation trauma' and 'ARDS'), the intervention ('nebulized', 'vaporized', and 'aerosolized') and anticoagulants limited to agents that are commercially available and frequently given or tested in critically ill patients ['heparin', 'danaparoid', 'activated protein C' (APC), 'antithrombin' (AT) and 'tissue factor pathway inhibitor' (TFPI)]. The systematic search identified 16 articles reporting on preclinical studies and 11 articles reporting on human trials. All nebulized anticoagulants attenuate pulmonary coagulopathy in preclinical studies using various models for lung injury, but the effects on inflammation are less consistent. Nebulized heparin, danaparoid and TFPI, but not APC and AT also reduced systemic coagulation. Nebulized heparin in lung injury patients shows contradictory results, and there is concern over systemic side effects of this strategy. Future studies need to focus on the way to nebulize anticoagulants, as well as on efficient but safe dosages, and other side effects.
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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.