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    Inhaled nitric oxide as rescue therapy in severe ARDS cases due to COVID-19 pneumonia: a single center experience
    (Verduci Publisher, 2023) Bicakcioglu, M.; Kalkan, S.; Duzenci, D.; Yalcinsoy, M.; Dogan, Z.; Ozer, A. B.
    OBJECTIVE: Inhaled NO (iNO) has been recommended as rescue therapy in acute respiratory stress syndrome (ARDS) cas-es. 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 retrospec-tive 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 de-mographic data, APACHE II and Sequential Or-gan Failure Assessment (SOFA) scores, initia-tion day of iNO and duration of iNO treatment, length of stay in hospital/ICU, blood biochem-istry values, complete blood counts, inflamma-tory parameters, arterial blood gas values, lac-tate, 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 pa-tients 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 ther-apy. A significant increase in PaO2/FiO2 val-ues 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 deter-mined that iNO applied as a rescue treatment in patients with severe ARDS improved oxygen-ation. Although the effect of iNO on survival was low, it may be interpreted as clinically signifi-cant considering the severity of the general clin-ical condition of the patients.
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    Management of mechanical ventilation in a morbidly obese patient with COVID-19-induced ARDS
    (Verduci Publisher, 2021) Demircan, S.; Disli, Z. Korkmaz; Kalkan, S.; Ozer, A. B.
    Coronavirus disease 2019-induced acute respiratory distress syndrome (AR-DS) is more severe in morbidly obese patients. Mechanical ventilation differs between obese and non-obese patients. We examined these differences in an obese (body mass index = 47 kg/m(2)) 32-year-old patient followed up in our clinic. The patient was admitted to the intensive care unit due to respiratory failure. Recruitment maneuvers were performed in pressure-controlled ventilation mode. The optimal positive end-expiratory pressure was 25 cm H2O. The inspiratory pressure was adjusted to 45 cm H2O to provide a tidal volume of 6 ml/kg and driving pressure <= 15. The patient was discharged with full recovery.