Background: Low-molecular-weight heparin (LMWH) is a part of standard supportive therapy for sepsis, but clinical research on anticoagulant therapy is still controversial. The aim of the present study was to explore the efficacy and safety of LMWH in adult septic patients by meta-analysis.
Methods: Information on randomized controlled trials was retrieved from PubMed, Embase, Web of Science, China National Knowledge Infrastructure, and China Wanfang Database from the establishment of each database to February 20, 2020. The therapeutic efficacy indexes of LMWH for adult septic patients were analyzed by Stata15.0 software.
Results: A total of 684 septic patients were included in 10 trials. The results showed that, compared with conventional treatment, LMWH significantly reduced prothrombin time [mean difference (MD) =-0.48, 95% confidence interval (CI): -0.83 to -0.13], Acute Physiology And Chronic Health Evaluation II score (MD=-4.42, 95% CI: -5.50 to -3.33), and 28-day mortality [relative risk (RR) =0.52, 95% CI: 0.38-0.70], and increased platelet count (MD =34.99, 95% CI: 23.37-46.60). LMWH significantly reduced levels of tumor necrosis factor-α, interleukin-6, and D-dimer, and the incidence of multiple organ dysfunction syndrome (MODS), with statistically significant differences. In addition, LMWH did not increase bleeding events (RR =1.29, 95% CI: 0.76-2.17).
Conclusions: On the basis of routine treatment, LMWH can improve coagulation function, reduce inflammatory reaction and the risk of bleeding, reduce the incidence of MODS and 28-day mortality rate, and improve the prognosis of adult patients with sepsis.
Keywords: Sepsis; low-molecular-weight heparin (LMWH); meta-analysis.