Inhaled nitric oxide as rescue therapy in severe ARDS cases due to COVID-19 pneumonia: a single center experience.

OBJECTIVE: Inhaled NO (iNO) has been recommended as rescue therapy in acute respiratory stress syndrome (ARDS) cases. In this study, we aimed to demonstrate the efficacy of iNO as a rescue therapy in patients with severe ARDS due to COVID-19. PATIENTS AND METHODS: This retrospective study included patients with ARDS due to COVID-19 who were treated with iNO between March 2020 and January 2022 in the intensive care unit (ICU) of Inonu University. Patients' files were reviewed retrospectively, and demographic data, APACHE II and Sequential Organ Failure Assessment (SOFA) scores, initiation day of iNO and duration of iNO treatment, length of stay in hospital/ICU, blood biochemistry values, complete blood counts, inflammatory parameters, arterial blood gas values, lactate, PaO2/FiO2 ratios, anti-inflammatory drugs and outcome were recorded. RESULTS: Data from 16 patients were reached. iNO was given at a dose of 20 ppm continuously. The mean duration of treatment with iNO was 3.5 days. All patients took the prone position except a single patient. While all patients received steroid therapy, four patients received anti-cytokine therapy, and five patients received intravenous immunoglobulin therapy. All patients were in severe ARDS with a mean PaO2/FiO2 ratio of 58 before iNO therapy. A significant increase in PaO2/FiO2 values was detected with the use of iNO (p<0.05). While three patients (19%) were discharged from the ICU, thirteen patients died. CONCLUSIONS: In our study, it was determined that iNO applied as a rescue treatment in patients with severe ARDS improved oxygenation. Although the effect of iNO on survival was low, it may be interpreted as clinically significant considering the severity of the general clinical condition of the patients.

The relationship of serum asprosin level with diabetic and non-diabetic retinopathy.

OBJECTIVE: This study was aimed at investigating the role of serum asprosin level in diabetic retinopathy pathogenesis and differential diagnosis diabetic and non-diabetic retinopathy. PATIENTS AND METHODS: The cross-sectional study was conducted between May 2021 and August 2021. A total of 21 subjects with diabetic retinopathy, 21 subjects with non-diabetic retinopathy, 21 subjects with type 2 diabetes mellitus (T2DM) without retinopathy and 21 healthy controls were included in the study. Biochemical parameters, serum asprosin, serum IL-6 and TNF-α levels were measured in all participants. RESULTS: Fasting blood glucose (FBG), HbA1c, HOMA-IR and LDL levels were higher in diabetic patients than non-diabetic. The blood asprosin levels were higher in the diabetic retinopathy group compared to the healthy control group (p=0.001), T2DM without diabetic retinopathy (p=0.010), and non-diabetic retinopathy group (p=0.043). There is a significant positive relationship between asprosin level and high FBG, HbA1c and HOMA-IR scores. CONCLUSIONS: Serum asprosin level is significantly increased in DRP group than others. A high asprosin level might be a risk factor for the development of diabetic complications, such as diabetic retinopathy. These findings suggest that the measurement of serum asprosin level may support clinicians in determining the risk of DRP development.

Predictive value of inflammatory and hematological data in diabetic and non-diabetic retinopathy.

OBJECTIVE: The current study aimed at investigating the predictive role of inflammatory, hematological and biochemical parameters in diabetic and non-diabetic retinopathy. MATERIALS AND METHODS: The cross-sectional study was conducted between June 2019 and September 2020. We included patients with diabetic retinopathy (proliferative DR=14, non-proliferative DR=16), patients with non-diabetic retinopathy (n=30), patients with Type 2 Diabetes Mellitus (T2DM) without retinopathy (n=30) and control group (n=30). Demographic, hematological, and biochemical parameters of the participants were examined. RESULTS: Participants' age and duration of diabetes mellitus were higher in proliferative and non-proliferative DR groups than patients with T2DM without retinopathy (p<0.001). There were significantly difference in terms of BMI (p<0.001), HbA1c (p<0.001), glucose (p<0.001), LDL (p<0.001), AST (p=0.001), hemoglobin (p<0.001), urea (p<0.001), creatinine (p<0.001), lymphocyte (p=0.001), and neutrophil (p=0.002) levels between groups. IL-6 levels were higher in proliferative DR, non-proliferative DR, and non-diabetic retinopathy groups than the control group. TNF-α levels were higher in proliferative DR and non-diabetic retinopathy groups than the control group. The NLR and PLR median values were significantly higher in the proliferative DR group than in other groups (p<0.001). CONCLUSIONS: The current study showed that IL-6 and TNF-α levels are elevated in diabetic and non-diabetic retinopathy. In addition, neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) median levels are higher in proliferative diabetic retinopathy than other groups. These findings support the inflammatory process may be accelerating the development of retinopathy.