COPD and eosinophils: a perspective from the intensive care unit

Abstract

Aims: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder characterized by airflow limitation and chronic airway inflammation. Various biomarkers have been investigated to better guide the treatment and predict the prognosis of COPD patients, among which blood eosinophil levels have received particular attention. Unlike many previous studies, our investigation specifically focuses on COPD patients in the intensive care unit (ICU), where disease severity is markedly higher Methods: Data from 141 COPD patients admitted to the ICU over a one-year period were retrospectively analyzed. The patients were classified into two groups based on their blood eosinophil counts; a low eosinophil group (0-100 cells/µl) and a moderate-high eosinophil group (>100 cells/µl). These groups were compared in terms of clinical scoring systems, laboratory parameters, and ICU-related clinical outcomes. Results: Patients with low eosinophil levels had higher levels of infection-related biomarkers, including procalcitonin, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio. Additionally, a weak positive correlation was observed between increasing eosinophil levels and partial carbon dioxide pressure. However, no statistically significant associations were found between eosinophil levels and outcomes such as mortality, tracheostomy requirement, or the need for inotropic support. Conclusion: In addition to its established role in predicting response to corticosteroid therapy, the peripheral blood eosinophil count may serve as a potential biomarker for guiding treatment strategies and prognostic evaluation in COPD exacerbations managed in the ICU. It should be noted that in COPD patients with higher eosinophil levels requiring intensive care follow-up, non-infectious exacerbations -such as those triggered by environmental exposures, medication nonadherence, or underlying airway inflammation- may be more prominent.

Keywords

• COPD
• eosinophil
• intensive care
• mortality
• respiratory disease

Supporting Institution

none

Ethical Statement

The study was performed in accordance with the Helsinki Declaration and was approved by the local ethics committee-Ankara Sanatorium Training and Research Hospital Clinical Research Ethics Committee (dated 11-12-2024 and decision number 2024-BÇEK 185).

Thanks

none

KOAH ve eozinofil: yoğun bakım penceresinden bir bakış

Abstract

Amaç: Kronik obstrüktif akciğer hastalığı (KOAH), hava akımı kısıtlanması ve kronik hava yolu inflamasyonu ile karakterize ilerleyici bir solunum hastalığıdır. KOAH hastalarının tedavi ve prognozunu daha iyi belirleyebilmek adına çeşitli biyobelirteçler araştırılmıştır ve bu biyobelirteçler arasında kan eozinofil düzeyleri dikkat çekmektedir. Bu çalışmada, KOAH alevlenmelerinde kan eozinofil düzeyleri ile klinik sonuçlar arasındaki ilişkinin değerlendirilmesi amaçlanmıştır. Yöntem: Yoğun bakım ünitesine (YBÜ) bir yıllık süre içerisinde kabul edilen 141 KOAH hastasına ait veriler retrospektif olarak analiz edilmiştir. Hastalar kan eozinofil düzeylerine göre iki gruba ayrılmıştır: düşük (0–100 hücre/µL) ve orta-yüksek (>100 hücre/µL) eozinofil grubu. Bu gruplar klinik skorlama sistemleri, laboratuar bulguları ve yoğun bakımdaki klinik sonlanımlarına göre karşılaştırılmıştır. Bulgular: Düşük eozinofil düzeyine sahip hastalarda prokalsitonin, nötrofil/lenfosit oranı (NLR) ve trombosit/lenfosit oranı (PLR) gibi enfeksiyon belirteçlerinin daha yüksek olduğu saptanmıştır. Ayrıca, eozinofil düzeyindeki artış ile parsiyel karbondioksit basıncı (pCO₂) arasında zayıf pozitif bir korelasyon gözlenmiştir. Bununla birlikte, kan eozinofil düzeyleri ile mortalite, trakeostomi gereksinimi veya inotropik destek ihtiyacı gibi sonuçlar arasında anlamlı bir ilişki bulunmamıştır. Sonuç: Kortikosteroidlere yanıt öngörüsündeki rolünün yanı sıra, kan eozinofil sayısı yoğun bakımda yönetilen KOAH alevlenmelerinde tedavi yaklaşımlarını yönlendirmede ve prognozu öngörmede potansiyel bir biyobelirteç olarak değerlendirilebilir. Eozinofil düzeyleri yüksek, yoğun bakımda takip gerektiren KOAH hastalarının non-enfeksiyöz atakların daha ön planda olduğu göz önünde bulundurulmalıdır.

Keywords

• koah
• eozinofil
• yoğun bakım
• mortalite
• solunum hastalıkları

Supporting Institution

yok

Ethical Statement

Çalışma Helsinki Deklarasyonu’na uygun olarak gerçekleştirilmiş ve Ankara Sanatoryum Eğitim ve Araştırma Hastanesi Klinik Araştırmalar Etik Kurulu tarafından onay alınarak yapılmıştır (tarih: 11.12.2024, karar no: 2024-BÇEK 185).

Thanks

yok

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