The impact of continuous intravenous administration of heparin on coagulation dysfunction and organ failure in patients with sepsis

This retrospective cohort study aimed to evaluate the effects of continuous intravenous heparin on coagulation dysfunction, organ failure, and clinical outcomes in sepsis patients. Data from sepsis patients admitted to the ICU of Hebei University Affiliated Hospital (2017-2023) were analyzed, comparing a heparin group (initial dose: 5 U/kg/h, with dosage adjustments targeting an APTT maintained at 1.0-1.5 times the normal value) with a control group receiving prophylactic subcutaneous low-molecular-weight heparin. Outcomes included platelet count, DIC score, SOFA score, 28-day mortality, and bleeding risk, assessed daily from admission to day 7. At baseline, both groups showed comparable platelet counts, DIC scores, and SOFA scores. By day 3, the heparin group exhibited significantly higher platelet counts than controls (p<0.05), a trend sustained through day 7. DIC scores in the heparin group became significantly lower than controls from day 4 onward (p<0.05). Similarly, SOFA scores in the heparin group were notably reduced compared to controls from day 5 to day 7 (p<0.05). However, no significant differences were observed in 28-day mortality (p>0.05) or bleeding risk between groups. The findings suggest that continuous intravenous heparin improves coagulation dysfunction (reflected by platelet recovery and reduced DIC scores) and mitigates organ failure (evidenced by lower SOFA scores) in sepsis patients. Despite these benefits, heparin did not reduce 28-day mortality. The study highlights heparin's potential role in managing sepsis-related complications but underscores the need for further research to optimize therapeutic strategies for mortality reduction.