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      Efficacy of low molecular weight heparin for chronic obstructive pulmonary disease and respiratory failure : A protocol of systematic review of randomized controlled trials

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          Abstract

          Background:

          Evaluating the efficacy and safety of low molecular weight heparin (LMWH) for patients with chronic obstructive pulmonary disease (COPD) and respiratory failure (RF) is a major purpose of this study.

          Methods:

          The following electronic databases will be comprehensively retrieved from the inception to July 1, 2019: Cochrane Library, PUBMED, EMBASE, Google Scholar, Web of Science, Allied and Complementary Medicine Database, WANGFANG, and China National Knowledge Infrastructure without language restrictions. All randomized controlled trials related to LMWH for COPD and RF will be included. Two authors will carry out study selection, data collection, and risk of bias assessment independently.

          Results:

          This study will systematically explore the efficacy and safety of LMWH for COPD and RF. The primary outcome is lung function. The secondary outcomes are severity of dyspnea on exertion, quality of life, body mass index, airflow obstruction; and any expected and unexpected adverse events.

          Conclusion:

          The findings of this study will provide evidence to judge whether LMWH is an effective treatment for patients with COPD and RF.

          PROSPERO registration number:

          PROSPERO CRD42019 139631.

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          Most cited references18

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          Update on Clinical Aspects of Chronic Obstructive Pulmonary Disease

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            Prevalence of comorbidities in chronic obstructive pulmonary disease patients

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              Management of acute exacerbations of chronic obstructive pulmonary disease: a summary and appraisal of published evidence.

              To review critically the available data on diagnostic evaluation, risk stratification, and therapeutic management of patients with acute exacerbations of chronic obstructive pulmonary disease (COPD). English-language articles were identified by searching MEDLINE (1966 to 2000, week 5), EMBASE (1974 to 2000, week 18), HealthStar (1975 to June 2000), and the Cochrane Controlled Trials Register (2000, Issue 1). The best available evidence on each subtopic was selected for analysis. Randomized trials, sometimes buttressed by cohort studies, were used to evaluate therapeutic interventions. Cohort studies were used to evaluate diagnostic tests and risk stratification. Study design and results were summarized in evidence tables. Individual studies were rated by internal validity, external validity, and quality of design. Statistical analyses of combined data were not performed. Data on the utility of most diagnostic tests are limited. However, chest radiography and arterial blood gas sampling seem useful while acute spirometry does not. Identifiable clinical variables are associated with risk for relapse and risk for death after hospitalization for an acute exacerbation. Evidence of efficacy was found for bronchodilators, corticosteroids, and noninvasive positive-pressure ventilation. There is also support for the use of antibiotics in patients with more severe exacerbations. On the basis of limited data, mucolytics and chest physiotherapy do not seem to be of benefit, and oxygen supplementation seems to increase the risk for respiratory failure only in an identifiable subgroup of patients. Although suggestions for appropriate management can be made on the basis of available evidence, the supporting literature is scarce and further high-quality research is necessary. Such research will require an improved, generally acceptable, and transportable definition of acute exacerbation of COPD, as well as improved methods for observing and measuring outcomes.
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                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Wolters Kluwer Health
                0025-7974
                1536-5964
                November 2019
                27 November 2019
                : 98
                : 48
                : e18051
                Affiliations
                [a ]Department of Respiratory Medicine, People's Hospital of Fuyang, Hangzhou
                [b ]Department of Respiratory Medicine, Hangzhou Fuyang Hospital of Traditional Chinese Medicine, Hangzhou, China.
                Author notes
                []Correspondence: Dejun Zhao, Department of Respiratory Medicine, People's Hospital of Fuyang, No.400 Jinqiaobei Road, Hangzhou 311400, China (e-mail: Dejun19970@ 123456hotmail.com ).
                Article
                MD-D-19-08166 18051
                10.1097/MD.0000000000018051
                6890332
                31770219
                eb613809-c789-4b02-b4be-124df1b8a9c2
                Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

                History
                : 21 October 2019
                : 22 October 2019
                Categories
                3700
                Research Article
                Study Protocol Systematic Review
                Custom metadata
                TRUE

                low molecular weight heparin,chronic obstructive pulmonary disease,respiratory failure,randomized controlled trial,efficacy,safety

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