Effect Of Hemocoagulase For Prevention Of Pulmonary Hemorrhage In Critical Newborns On Mechanical Ventilation: A Randomized Controlled Trial

Objective: To investigate the role of hemocoagulase to prevent pulmonary hemorrhage in critical newborns on mechanical ventilation. Design: Randomized controlled trial. Setting: Neonatal Intensive Care Unit of an affiliated hospital of a Medical University. Children: Seventy-two critical newborn infants on mechanical ventilation. Intervention: The involved neonates were divided randomly into two groups. Forty-one patients were treated with prophylactic hemocoagulase(dripped through the endotracheal tube), and other 31 neonates served as controls. Outcome Measures: Incidence of pulmonary hemorrhage, time of ceasing pulmonary hemorrhage if occurred, time of withdrawing of mechanical ventilation in the survivors, and mortality. Results: The incidence of pulmonary hemorrhage (12% vs 42%) and the time of ceasing pulmonary hemorrhage (1.36 +/- 0.65 vs 3.58 +/- 0.82, days), were significantly less in infants treated with prophylactic hemocoagulase as compared with the controls (P<0.05). The time to withdrawal of mechanical ventilation was less in the intervention group (3.20 +/- 0.45 vs 5.04 +/- 1.51 days) (P<0.05). The mortality in children who received hemocoagulase was 22.0%, which was significantly less than controls (41.9%)(P<0.05). Conclusion: Prophylactic use of hemocoagulase in mechanically ventilated neonates is effective against pulmonary hemorrhage.