title: Efficacy and safety of low-molecular-weight heparin in patients with sepsis: a meta-analysis of randomized controlled trials.
abstract: Low-molecular-weight heparin (LMWH) is part of standard supportive care. We conducted a meta-analysis to investigate the efficacy and safety of LMWH in septic patients. We searched Pubmed, Embase, CKNI and Wanfang database prior to July 2015 for randomized controlled trials investigating treatment with LMWH in septic patients. We identified 11 trials involving 594 septic patients. Meta-analysis showed that LMWH significantly reduced prothrombin time (mean differences [MD] -0.88; 95% CI -1.47 to -0.29), APACHE II score (MD -2.50; 95% CI -3.55 to -1.46), and 28-day mortality (risk ratio [RR] 0.72; 95% CI 0.57-0.91) as well as increased the platelet counts (MD 18.33; 95% CI 0.73-35.93) than the usual treatment. However, LMWH did not reduce D-dimer (MD -0.34; 95% CI -0.85 to 0.18). LMWH also significantly increased the bleeding events (RR 3.82; 95% CI 1.81-8.08). LMWH appears to reduce 28-day mortality and APACHE II score among septic patients. Bleeding complications should be monitored during the LMWH treatment. As for limited data about LMWH and sepsis in the English literature, only trials published in the Chinese were included in the meta-analysis.
authors.affiliation: Institute of Molecular Biology &Translational Medicine, the Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu, PR China (212002).
authors.forename: Yu
authors.initials: Y
authors.lastname: Fan
authors.affiliation: Institute of Molecular Biology &Translational Medicine, the Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu, PR China (212002).
authors.forename: Menglin
authors.initials: M
authors.lastname: Jiang
authors.affiliation: Institute of Molecular Biology &Translational Medicine, the Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu, PR China (212002).
authors.forename: Dandan
authors.initials: D
authors.lastname: Gong
authors.affiliation: Department of general surgery, the Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu, PR China (212002).
authors.forename: Chen
authors.initials: C
authors.lastname: Zou
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D016207:Cytokines / Q000378:metabolism; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced / Q000453:epidemiology; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D016032:Randomized Controlled Trials as Topic; D018805:Sepsis / Q000150:complications* / Q000276:immunology; D016019:Survival Analysis
chemical_list: D000925:Anticoagulants; D016207:Cytokines; D006495:Heparin, Low-Molecular-Weight