Clinical Application Of Heparin In The Treatment Of Sepsis

Objective To evaluate the clinical significance of unfractionated heparin in the treatment of sepsis through retrospective analysis of the inflammatory response,blood coagulation score,systemic organ function and prognosis.Methods This study included the patients,who were admitted to the emergency intensive care unit(EICU)of Ruijin Hospital from January 2014 to December 2018 and diagnosed with sepsis.According to the inclusion and exclusion criteria,a total of46 patients were included.According to whether they received heparin treatment,the patients were divided into two groups: the control group and the heparin treatment group.In the control group,25 patients were not treated with heparin anticoagulation therapy.In the other group,21 patients were given intravenous heparin at a small dose(total daily dose <150U/kg).Each patient was given life monitoring,antibiotic,vital organ function maintenance,and fluid regulation etc.Organ function evaluation,infection index and coagulation function were used as the analysis indexes.A total of6 time points were selected in the study: the day before the study(D0),the day after the treatment(D1,D2,D3,D7),and the day patients left ICU(DL).The course was summarized as the treatment began.In addition,ICU residence time(d),28-day survival,60-day survival,and final prognosis of the patients were recorded,and the therapeutic effect and safety of heparin were comprehensively in the end.Results In terms of organ function,since D7,the heparin treatment group showed a significant decrease compared with the previous time point.Furthermore,the decreases in D7 and DL were significantly greater than those in the control group(P<0.05).In terms of infection,after comprehensive analysis of the levels of white blood cell count,CRP and PCT in two groups,it was found that,starting from D7,heparin treatment group had a significant decline compared with the previous time point of its own,especially the decreases of CRP and PCT in D7 and DL were greater than those in the control group(P <0.05).In terms of coagulation function,since D7,the PLT count in the heparin treatment group has significantly increased compared with the previous time point(P <0.05),while the ISTH score has significantly decreased compared with the time point before itself and the range was greater than that in the control group(P <0.05).The length of stay in the ICU,28-day survival,60-day survival and final prognosis of the patients were analyzed.However,no significant improvement was found in the heparin treatment group.The incidence of adverse events such as bleeding and allergy did not increase significantly.Conclusion The effect of unfractionated heparin showed certain time dependence.In heparin treatment group,the function of vital organs was significantly restored,the coagulation function was improved,and the inflammation was alleviated.At the same time,the incidence of bleeding,allergy and other adverse events did not increase significantly.