St Vincent’s Melbourne Intensivist Dr Barry Dixon is proposing a trial of nebulized Heparin in COVID-19 patients. He has done extensive research in using nebulized Heparin in Acute Respiratory Distress Syndrome (ARDS) patients. A phase 1 trial was published in 2008, further data was presented in 2010, and he is now awaiting publication of a multicentre, randomized, double-blind clinical trial. Whilst he can’t comment on the specific results of the unpublished trial, all his research suggests that nebulized Heparin reduces lung injury and most importantly it is a safe intervention.

Application in COVID-19

There are several reasons nebulized Heparin may benefit COVID-19 patients:

“COVID-19 is associated with the development of ARDS displaying the typical features of diffuse alveolar damage with extensive pulmonary coagulation activation resulting in fibrin deposition in the microvasculature and formation of hyaline membranes in the air sacs. The anti-coagulant actions of nebulised heparin limit fibrin deposition and progression of lung injury. Serendipitously, unfractionated heparin also inactivates the SARS-CoV-2 virus and prevents its entry into mammalian cells. Nebulisation of heparin may therefore limit both fibrin-mediated lung injury and inhibit pulmonary infection by SARS-CoV2.”

Can Nebulised Heparin Reduce Time to Extubation in SARS-CoV-2 (CHARTER Study) – Protocol

Next steps

Dr Dixon is working with other Intensive Care Units from around Australia and overseas to move the study forward. You can view the study protocol here. Due to the low numbers of critically ill COVID-19 patients in Australia, the study aims to recruit patients from overseas Intensive Care Units.

Read about this news in the media by following the link to The Age or read about other research at St Vincent’s Melbourne ICU.