Heparin treatment for animal model with smoke inhalation injury: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

TIAN Fangyuan ^1,2# , WU Bin ^1# ,  XU Ting ¹

1. Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;
2. West China School of Pharmacy, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding?author：

XU Ting, Email: tingx2009@163.com

Keywords：

Heparin; Smoke inhalation injury; Animal experiments; Meta-analysis; Systematic review; SYRCLE

DOI：

10.7507/1672-2531.201612047

Video：

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Objective To systematically review the effectiveness and model building process of heparin treatment for animal model with smoke inhalation injury. Methods Databases including PubMed, EMbase, CBM, CNKI, VIP and WanFang Data were searched to collect animal experiments about the treatment of heparin for animal model with smoke inhalation injury from inception to November 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was conducted by RevMan 5.3 software. Results A total of nine studies involving 11 animal experiments were included. The results showed that building animal model with smoke inhalation injury were through burning of cotton towels or pine sawdust by sheep or rats below 40℃. The results of meta-analysis showed that there was no significant difference in mortality rate between two groups (heparin group vs. control group: RR=0.38, 95%CI 0.14 to 1.05, P=0.06; heparin plus DMSO group vs. DMSO group: RR=0.10, 95%CI 0.01 to 1.51, P=0.10). In addition, the pulmonary artery pressure (MD=–3.31, 95%CI –4.51 to –2.11, P<0.000 01), wet to dry weight ratio (MD=–0.90, 95%CI –1.19 to –0.61, P<0.000 01), and lung water content (MD=–1.18, 95%CI –1.67 to –0.70, P<0.000 01) of the experimental group were lower than those in the control group. PaO₂/FiO₂ after 12 hours (MD=131.00, 95%CI 59.54 to 202.46, P=0.000 3), PaO₂/FiO₂ after 24 hours (MD=114.00, 95%CI 60.56 to 167.44, P<0.000 1), PaO₂/FiO₂ after 48 hours (MD=46.00, 95%CI 20.62 to 71.38, P=0.000 4) were higher than those in the control group. However, there was no significant difference in coagulation function between both groups. Conclusion The current evidence shows that the establishment of animal model of smoke inhalation injury is still lack of standard method. Heparin can decrease pulmonary artery pressure and lung water content in animal models with smoke inhalation injury. Due to the limited quality and quantity of included studies, the above conclusions are still needed to be verified by more high quality studies.

Citation： TIAN Fangyuan, WU Bin, XU Ting. Heparin treatment for animal model with smoke inhalation injury: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2017, 17(6): 705-710. doi: 10.7507/1672-2531.201612047 Copy

1.	世界衛生組織燒傷實況報道第 365 號. 2016 年 9 月. Available at: http://www.who.int/mediacenter/factsheets/fs365/zh/.
2.	柴家科. 實用燒傷外科學. 北京: 人民軍醫出版社, 2014: 300-310.
3.	包校偉, 袁華, 吳忠好, 等. 燒傷治療 5235 例回顧分析. 中國現代手術學雜志, 2015, 19(5): 379-380.
4.	National Burn Repository, 2015 report: American Burn Association, 2015. Avaliable at: http://www.ameriburn. org/2015NBRAnnualReport.pdf.
5.	Toon MH, Maybauer MO, Greenwood JE, et al. Management of acute smoke inhalation injury. Crit Care Resusc, 2010, 12(1): 53-61.
6.	吳斌, 田方圓, 占美, 等. 大鼠燒傷模型構建實驗的系統評價. 中國循證醫學雜志, 2016, 16(11): 1354-1359.
7.	Hooijmans CR, Tillema A, Leenaars M, et al. Enhancing search efficiency by means of a search filter for finding all studies on animal experimentation in PubMed. Lab Anim, 2010, 4(3): 170-175.
8.	Hooijmans C, Rovers MM, de Vries RB, et al. SYRCLE’s risk of bias tool for animal studies. BMC Med Res Methodol, 2014, 5(14): 43.
9.	Brown M, Desai M, Traber LD, et al. Dimethylsulfoxide with heparin in the treatment of smoke inhalation injury. J Burn Care Rehabil, 1988, 9(1): 22-25.
10.	Kimura R, Traber LD, Herndon DN, et al. Treatment of smoke-induced pulmonary injury with nebulized dimethylsulfoxide. Circ Shock, 1988, 25(4): 333-341.
11.	Cox Jr CS, Zwischenberger JB, Traber DL, et al. Heparin improves oxygenation and minimizes barotrauma after severe smoke inhalation in an ovine model. Surg Gynecol Obstet, 1993, 176(4): 339-349.
12.	Murakami K, McGuire R, Cox RA, et al. Heparin nebulization attenuates acute lung injury in sepsis following smoke inhalation in sheep. Shock, 2002, 18(3): 236-241.
13.	Tasaki O, Mozingo DW, Dubick MA, et al. Effects of heparin and lisofylline on pulmonary function after smoke inhalation injury in an ovine model. Crit Care Med, 2002, 30(3): 637-643.
14.	Murakami K, Enkhbaatar P, Shimoda K, et al. High-dose heparin fails to improve acute lung injury following smoke inhalation in sheep. Clin Sci (Lond), 2003, 104(4): 349-356.
15.	Enkhbaatar P, Cox RA, Traber LD, et al. Aerosolized anticoagulants ameliorate acute lung injury in sheep after exposure to burn and smoke inhalation. Crit Care Med, 2007, 35(12): 2805-2810.
16.	付瀟瀟, 劉群. 低分子肝素對吸入性損傷大鼠肺愈合的影響. 天津醫科大學學報, 2009, 15(4): 554-556.
17.	付瀟瀟, 劉群, 耿輝. 低分子肝素聯合表皮細胞生長因子對吸入性損傷大鼠肺治療效果的研究. 中華損傷與修復雜志, 2009, 4(5): 532-537.
18.	溫豐平, 謝衛國, 蔣南紅. 肝素對燒傷治療作用的系統評價. 中華損傷與修復雜志, 2011, 6(4): 533-542.

1. 世界衛生組織燒傷實況報道第 365 號. 2016 年 9 月. Available at: http://www.who.int/mediacenter/factsheets/fs365/zh/.
2. 柴家科. 實用燒傷外科學. 北京: 人民軍醫出版社, 2014: 300-310.
3. 包校偉, 袁華, 吳忠好, 等. 燒傷治療 5235 例回顧分析. 中國現代手術學雜志, 2015, 19(5): 379-380.
4. National Burn Repository, 2015 report: American Burn Association, 2015. Avaliable at: http://www.ameriburn. org/2015NBRAnnualReport.pdf.
5. Toon MH, Maybauer MO, Greenwood JE, et al. Management of acute smoke inhalation injury. Crit Care Resusc, 2010, 12(1): 53-61.
6. 吳斌, 田方圓, 占美, 等. 大鼠燒傷模型構建實驗的系統評價. 中國循證醫學雜志, 2016, 16(11): 1354-1359.
7. Hooijmans CR, Tillema A, Leenaars M, et al. Enhancing search efficiency by means of a search filter for finding all studies on animal experimentation in PubMed. Lab Anim, 2010, 4(3): 170-175.
8. Hooijmans C, Rovers MM, de Vries RB, et al. SYRCLE’s risk of bias tool for animal studies. BMC Med Res Methodol, 2014, 5(14): 43.
9. Brown M, Desai M, Traber LD, et al. Dimethylsulfoxide with heparin in the treatment of smoke inhalation injury. J Burn Care Rehabil, 1988, 9(1): 22-25.
10. Kimura R, Traber LD, Herndon DN, et al. Treatment of smoke-induced pulmonary injury with nebulized dimethylsulfoxide. Circ Shock, 1988, 25(4): 333-341.
11. Cox Jr CS, Zwischenberger JB, Traber DL, et al. Heparin improves oxygenation and minimizes barotrauma after severe smoke inhalation in an ovine model. Surg Gynecol Obstet, 1993, 176(4): 339-349.
12. Murakami K, McGuire R, Cox RA, et al. Heparin nebulization attenuates acute lung injury in sepsis following smoke inhalation in sheep. Shock, 2002, 18(3): 236-241.
13. Tasaki O, Mozingo DW, Dubick MA, et al. Effects of heparin and lisofylline on pulmonary function after smoke inhalation injury in an ovine model. Crit Care Med, 2002, 30(3): 637-643.
14. Murakami K, Enkhbaatar P, Shimoda K, et al. High-dose heparin fails to improve acute lung injury following smoke inhalation in sheep. Clin Sci (Lond), 2003, 104(4): 349-356.
15. Enkhbaatar P, Cox RA, Traber LD, et al. Aerosolized anticoagulants ameliorate acute lung injury in sheep after exposure to burn and smoke inhalation. Crit Care Med, 2007, 35(12): 2805-2810.
16. 付瀟瀟, 劉群. 低分子肝素對吸入性損傷大鼠肺愈合的影響. 天津醫科大學學報, 2009, 15(4): 554-556.
17. 付瀟瀟, 劉群, 耿輝. 低分子肝素聯合表皮細胞生長因子對吸入性損傷大鼠肺治療效果的研究. 中華損傷與修復雜志, 2009, 4(5): 532-537.
18. 溫豐平, 謝衛國, 蔣南紅. 肝素對燒傷治療作用的系統評價. 中華損傷與修復雜志, 2011, 6(4): 533-542.

Chinese Journal of Evidence-Based Medicine

Heparin treatment for animal model with smoke inhalation injury: a meta-analysis

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