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

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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.	世界卫生组织烧伤实况报道第 365 号. 2016 年 9 月. Available at: http://www.who.int/mediacenter/factsheets/fs365/zh/.
2.	柴家科. 实用烧伤外科学. 北京: 人民军医出版社, 2014: 300-310.
3.	包校伟, 袁华, 吴忠好, 等. 烧伤治疗 5235 例回顾分析. 中国现代手术学杂志, 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.	吴斌, 田方圆, 占美, 等. 大鼠烧伤模型构建实验的系统评价. 中国循证医学杂志, 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.	付潇潇, 刘群. 低分子肝素对吸入性损伤大鼠肺愈合的影响. 天津医科大学学报, 2009, 15(4): 554-556.
17.	付潇潇, 刘群, 耿辉. 低分子肝素联合表皮细胞生长因子对吸入性损伤大鼠肺治疗效果的研究. 中华损伤与修复杂志, 2009, 4(5): 532-537.
18.	温丰平, 谢卫国, 蒋南红. 肝素对烧伤治疗作用的系统评价. 中华损伤与修复杂志, 2011, 6(4): 533-542.

1. 世界卫生组织烧伤实况报道第 365 号. 2016 年 9 月. Available at: http://www.who.int/mediacenter/factsheets/fs365/zh/.
2. 柴家科. 实用烧伤外科学. 北京: 人民军医出版社, 2014: 300-310.
3. 包校伟, 袁华, 吴忠好, 等. 烧伤治疗 5235 例回顾分析. 中国现代手术学杂志, 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. 吴斌, 田方圆, 占美, 等. 大鼠烧伤模型构建实验的系统评价. 中国循证医学杂志, 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. 付潇潇, 刘群. 低分子肝素对吸入性损伤大鼠肺愈合的影响. 天津医科大学学报, 2009, 15(4): 554-556.
17. 付潇潇, 刘群, 耿辉. 低分子肝素联合表皮细胞生长因子对吸入性损伤大鼠肺治疗效果的研究. 中华损伤与修复杂志, 2009, 4(5): 532-537.
18. 温丰平, 谢卫国, 蒋南红. 肝素对烧伤治疗作用的系统评价. 中华损伤与修复杂志, 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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