Interventions
Participants assigned to “nebulised UFH” receive nebulised UFH in addition to the standard care required as determined by the treating team. The dose, frequency, duration and delivery method differ between participating studies as follows:
Participants assigned to ‘standard care’ will receive the standard care required as determined by the treating team and will not be treated with nebulised heparin.
Nebulised UFH will be stopped if the patient has been intubated and commenced on invasive mechanical ventilation.
Nebulised UFH will be withheld if any of the following occurs:
- The treating physician deems that there is a clinically unacceptable increase in APTT
- The treating physician deems that there is excessive bloodstaining of respiratory secretions
- There is pulmonary bleeding, major bleeding or suspected or confirmed heparin-induced thrombocytopaenia (HIT)
Nebulised UFH will be recommenced if:
- Having been withheld because the APTT was unacceptably prolonged, the APTT becomes acceptable
- Having been withheld because there was excessive bloodstaining of upper or lower respiratory secretions, the bloodstaining of the respiratory secretions has resolved
- Having been withheld for pulmonary bleeding or major bleeding, the bleeding is definitively controlled
- Having been withheld for suspected HIT, the patient is found not to have this condition