A Clinical Study On Acute Lung Injury/Acute Respiratory Distress Syndrome Treated With Ultrasonic Atomizing Inhalaiton Of Low Molecular Weight Heparin

Objective To investigate the effects and possible mechanism of ultrasonic atomizinginhalation of Low Molecular Weight Heparin (LMWH) in ALI/ARDS patients.Methods (1)Experimental grouping: A total of42ALI/ARDS patients were randomlydivided into control group(9samples), subcutaneous group(15samples) and atomizationgroup(18samples).(2) Experimental method: Patients in the control group were treatedwith routine therapy including fighting infection, respiratory support, nutritional support,maintaining electrolyte and acid-base balance, ultrasonic aerosolized eliminatingphlegm. Patients in the subcutaneous group received subcutaneous injection of LMWHNa (5000IU, q12h) based on routine therapy. The atomization group was treated withultrasonic atomizing inhalation of LMWH Na (5000IU,q12h) based on routine therapy.We observed and compared the three groups with7days oxygen index,APACHE Ⅱ scores, IL-6and PLT, APTT change, bleeding, and7days mortality.Results Three groups:(1) The7days oxygen index of each group increased thanbefore(P<0.05). Anticoagulation group was better than control group (P <0.01). Theoxygen index of atomization group was higher than subcutaneous group(P<0.05).(2)The7days IL-6of each group significantly decreased than before(P<0.05). The after-7day IL-6of anticoagulation group was lower than control group (P<0.01), whileatomization group of IL-6were higher than subcutaneous group(P<0.05).(3)The7days APACHE Ⅱs cores of each group were lower than before(P<0.05). The after-7dayAPACHE Ⅱscores of anticoagulation group was lower than control group (P<0.05).IL-6and APACHEⅡ scores of subcutaneous group and atomization group werepositively correlated（P<0.05）.(4) PLT and APTT of the three groups have nosignificant difference during pre-and-pro treatments (P>0.05). There has no differencebetween anticoagulation group and controls group with the comparison of after-7dayPLT and APTT(P>0.05).(5) The mortality rates of subcutaneous group, atomizationgroup, control group were12.5%,11.1%,37.5%. There was no difference between thethree groups (P>0.05)Conclusions Ultrasonic atomizing inhalation and subcutaneous injection of LowMolecular Weight Heparin could improve ventilate function and rise oxygenation index.The method of ultrasonic atomizing inhalation is better than subcutaneous injection way.while LMWH could activate fibrinolysis system and inhibit the release of IL-6, reducesystemic inflammation, which can eventually reduce the severity of the patients.