Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Nebulized heparin reduces levels of pulmonary coagulation activation in acute lung injury. | Dixon et al. Critical Care 2010 14 445 http content 14 5 445 CRITICAL CARE LETTER L_ Nebulized heparin reduces levels of pulmonary coagulation activation in acute lung injury Barry Dixon 1 Marcus J Schultz2 Jorrit J Hofstra2 Duncan J Campbell3 4 and John D Santamaria1 See related research by Dixon etal. http content 12 3 R64 Previously in this journal we published a phase 1 study of nebulized heparin in patients with acute lung injury 1 . Patients were administered heparin at doses of 50 000 100 000 200 000 or 400 000 U day for 2 days and bronchoalveolar lavage BAL fluid samples were taken at baseline and after the last heparin dose. The study demonstrated a trend to reduced coagulation activation prothrombin fragments in BAL fluid after the last dose of nebulized heparin 1 . Following publication of these data we were offered the possibility of further analysis of the BAL fluid with additional markers of coagulation activation including thrombin-antithrombin complexes TATcs fibrin degradation products FDPs and plasminogen activator activity PAI-1 levels. We wish to publish the results of this further analysis. The 400 000 U day group had one patient more than the same group in the previously published data. We found that TATc and FDP levels were significantly reduced in patients treated with 400 000 U day of nebulized heparin but not PAI-1 Figure 1 overleaf . We believe that these data are important as they demonstrate for the first time that nebulized heparin significantly reduces coagulation activation in the lungs of critically ill patients with acute lung injury. This may be important knowledge as inflammatory mechanisms related to coagulation activation such as hyaline membrane formation and microvascular thrombosis may mediate lung injury 2 3 . Abbreviations BAL bronchoalveolar lavage FDR fibrin degradation product PAI-1 plasminogen activator activity TATc thrombin-antithrombin complex. Competing interests The authors declare .
