Document Detail

Heparin improves gas exchange during experimental acute lung injury in newborn piglets.
MedLine Citation:
PMID:  9817717     Owner:  NLM     Status:  MEDLINE    
Although intrapulmonary fibrin deposition is a pathognomonic feature of acute lung injury, it remains uncertain whether thrombin inhibitors affect clinically important outcomes. We hypothesized that both heparin and antithrombin (AT) concentrate improve gas exchange during experimental respiratory distress syndrome. We also tested whether combination therapy is more beneficial than monotherapy. Forty-eight newborn piglets were randomized within 12 litters to one of four groups in a factorial design: (1) AT; (2) heparin; (3) AT plus heparin; (4) untreated control animals. After lung lavage and 4 h of barovolutrauma, mechanical ventilation was continued for 24 h during which ventilator pressures and inspired oxygen were adjusted to maintain normal blood gases. The arterial/ alveolar oxygen tension ratio (a/A ratio) and the ventilator efficiency index (VEI) at 18 and 24 h were compared by repeated measures analysis of variance (ANOVA). In contrast to our hypothesis, only heparin improved gas exchange, and we found little evidence of an interaction with AT. The a/A ratio was 0.48 +/- 0.27 (mean +/- SD) in the presence of heparin versus 0.33 +/- 0.26 in its absence; p = 0.01. Corresponding VEI was 0.30 +/- 0.12 versus 0.25 +/- 0.14; p = 0.04. Hyaline membrane formation was also decreased in heparin-treated animals (p = 0.02).
K Abubakar; B Schmidt; S Monkman; C Webber; D deSA; R Roberts
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  158     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1998-12-18     Completed Date:  1998-12-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1620-5     Citation Subset:  AIM; IM    
Departments of Pediatrics, Radiology, Pathology, and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
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MeSH Terms
Analysis of Variance
Anticoagulants / administration & dosage,  therapeutic use*
Antithrombin III / administration & dosage,  therapeutic use
Disease Models, Animal
Drug Combinations
Follow-Up Studies
Heparin / administration & dosage,  therapeutic use*
Lung / pathology
Oxygen / administration & dosage,  blood
Pulmonary Gas Exchange / drug effects*
Random Allocation
Respiration, Artificial
Respiratory Distress Syndrome, Adult / drug therapy*,  pathology,  physiopathology
Serine Proteinase Inhibitors / administration & dosage,  therapeutic use
Treatment Outcome
Ventilation-Perfusion Ratio
Reg. No./Substance:
0/Anticoagulants; 0/Drug Combinations; 0/Serine Proteinase Inhibitors; 7782-44-7/Oxygen; 9000-94-6/Antithrombin III; 9005-49-6/Heparin

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