Is inhaled prophylactic heparin useful for prevention and Management of Pneumonia in ventilated ICU patients? The IPHIVAP investigators of the Australian and New Zealand Intensive Care Society Clinical Trials Group

Thumbnail Image
File version

Accepted Manuscript (AM)

Bandeshe, Hiran
Boots, Rob
Dulhunty, Joel
Dunlop, Rachael
Holley, Anthony
Jarrett, Paul
Gomersall, Charles D
Lipman, Jeff
Lo, Thomas
O'Donoghue, Steven
Paratz, Jenny
Paterson, David
Roberts, Jason A
Starr, Therese
Stephens, Di
Stuart, Janine
Thomas, Jane
Udy, Andrew
White, Hayden
Griffith University Author(s)
Primary Supervisor
Other Supervisors
File type(s)

Purpose: To determine whether prophylactic inhaled heparin is effective for the prevention and treatment of pneumonia patients receiving mechanical ventilation (MV) in the intensive care unit. Methods: A phase 2, double blind randomized controlled trial stratified for study center and patient type (nonoperative, post-operative) was conducted in three university-affiliated intensive care units. Patients aged ≥18 years and requiring invasive MV for more than 48 hours were randomized to usual care, nebulization of unfractionated sodium heparin (5000 units in 2 mL) or placebo nebulization with 0.9% sodium chloride (2 mL) four times daily with the main outcome measures of the development of ventilator associated pneumonia (VAP), ventilator associated complication (VAC) and sequential organ failure assessment scoresin patientswith pneumonia on admission or who developed VAP. Trial Registration: Australian and New Zealand Clinical Trials Registry ACTRN12612000038897. Results: Two hundred and fourteen patients were enrolled (72 usual care, 71 inhaled sodium heparin, 71 inhaled sodium chloride). There were no differences between treatment groups in terms of the development of VAP, using either Klompas criteria (6–7%, P = 1.00) or clinical diagnosis (24–26%, P = 0.85). There was no difference in the clinical consistency (P = 0.70), number (P = 0.28) or the total volume of secretions per day (P = .54). The presence of blood in secretions was significantly less in the usual care group (P = 0.005). Conclusion: Nebulized heparin cannot be recommended for prophylaxis against VAP or to hasten recovery from pneumonia in patients receiving MV.

Journal Title

Journal of Critical Care

Conference Title
Book Title


Thesis Type
Degree Program
Publisher link
Patent number
Grant identifier(s)
Rights Statement
Rights Statement

© 2016 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.

Item Access Status
Access the data
Related item(s)

Clinical sciences

Clinical sciences not elsewhere classified


Persistent link to this record