<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Introduction</h3>
<p>Acute respiratory distress syndrome (ARDS) represents a major cause of mortality in the intensive care unit (ICU). The inflammatory response is escalated by the cytokines and chemokines released by neutrophils, therefore the search for quantifying the impact of this pathophysiological mechanism is imperative. Neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) are indicators of systemic inflammation, widely accessible, inexpensive, and uncomplicated parameters.</p>
</sec>
<sec><h3>Methods</h3>
<p>We conducted a prospective study between March 2023 and June 2023 on patients which presented Berlin criteria for the diagnosis of ARDS during the first 24 hours from admission in the ICU. We included 33 patients who were divided into two groups: one group of 11 patients with severe ARDS and the second group of 22 patients with moderate/mild ARDS. The study evaluated demographic characteristics, leukocyte, lymphocyte, neutrophil, and platelet counts, as well as NLR and PLR values from complete blood count, and severity scores (APACHE II score and SOFA score). We investigated the correlation of NLR and PLR in the two main groups (severe and moderate/mild acute respiratory distress syndrome patients).</p>
</sec>
<sec><h3>Results</h3>
<p>For the NLR ratio statistically significant differences between the two groups are noted: Severe ARDS 24.29(1.13–96) vs 15.67(1.69–49.71), p=0.02 For the PLR ratio, we obtained significant differences within the group presenting severe ARDS 470.3 (30.83–1427) vs. the group presenting mild/moderate ARDS 252.1 (0–1253). The difference between the two groups is statistically significant (0.049, p&lt;0.05). The cut-off value of NLR resulted to be 23.64, with an Area Under the Curve (AUC) of 0.653 (95% CI: 0.43–0.88). The best cut-off value of PLR was performed to be 435.14, with an Area Under the Curve (AUC) of 0.645 (95% CI: 0.41–0.88).</p>
</sec>
<sec><h3>Conclusion</h3>
<p>Our study showed that NLR and PLR ratios 24 hours in patients with moderate/severe ARDS diagnosis can be a good predictor for severity of the disease. These biomarkers could be used in clinical practice due to their convenience, inexpensiveness, and simplicity of parameters. However, further investigations with larger populations of ARDS patients are necessary to support and validate these current findings.</p>
</sec>
</abstract>

Introduction
Acute respiratory distress syndrome (ARDS) represents a major cause of mortality in the intensive care unit (ICU). The inflammatory response is escalated by the cytokines and chemokines released by neutrophils, therefore the search for quantifying the impact of this pathophysiological mechanism is imperative. Neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) are indicators of systemic inflammation, widely accessible, inexpensive, and uncomplicated parameters.

Methods
We conducted a prospective study between March 2023 and June 2023 on patients which presented Berlin criteria for the diagnosis of ARDS during the first 24 hours from admission in the ICU. We included 33 patients who were divided into two groups: one group of 11 patients with severe ARDS and the second group of 22 patients with moderate/mild ARDS. The study evaluated demographic characteristics, leukocyte, lymphocyte, neutrophil, and platelet counts, as well as NLR and PLR values from complete blood count, and severity scores (APACHE II score and SOFA score). We investigated the correlation of NLR and PLR in the two main groups (severe and moderate/mild acute respiratory distress syndrome patients).

Results
For the NLR ratio statistically significant differences between the two groups are noted: Severe ARDS 24.29(1.13–96) vs 15.67(1.69–49.71), p=0.02 For the PLR ratio, we obtained significant differences within the group presenting severe ARDS 470.3 (30.83–1427) vs. the group presenting mild/moderate ARDS 252.1 (0–1253). The difference between the two groups is statistically significant (0.049, p<0.05). The cut-off value of NLR resulted to be 23.64, with an Area Under the Curve (AUC) of 0.653 (95% CI: 0.43–0.88). The best cut-off value of PLR was performed to be 435.14, with an Area Under the Curve (AUC) of 0.645 (95% CI: 0.41–0.88).

Conclusion
Our study showed that NLR and PLR ratios 24 hours in patients with moderate/severe ARDS diagnosis can be a good predictor for severity of the disease. These biomarkers could be used in clinical practice due to their convenience, inexpensiveness, and simplicity of parameters. However, further investigations with larger populations of ARDS patients are necessary to support and validate these current findings.

Neutrophil-to-Lymphocyte Ratio and Thrombocyte-to-Lymphocyte Ratio as a Predictor of Severe and Moderate/Mild Acute Respiratory Distress Syndrome Patients: Preliminary Results

Department of Anesthesiology and Intensive Care Medicine

Department of Anesthesiology and Intensive Care Medicine, Faculty of General Medicine

George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures

The Journal of Critical Care Medicine

This work is licensed under the Creative Commons Attribution 4.0 International License.

Introduction
Acute respiratory distress syndrome (ARDS) represents a major cause of mortality in the intensive care unit (ICU). The inflammatory response is...

Neutrophil-to-Lymphocyte Ratio and Thrombocyte-to-Lymphocyte Ratio as a Predictor of Severe and Moderate/Mild Acute Respiratory Distress Syndrome Patients: Preliminary Results

Article Category: Research Article

Published Online: Jan 30, 2024

Page range: 49 - 55

Received: Jul 01, 2023

Accepted: Dec 08, 2023

DOI: https://doi.org/10.2478/jccm-2024-0005

Keywords
acute respiratory distress syndrome, neutrophil-to-lymphocyte ratio, thrombocyte-to-lymphocyte ratio

© 2024 Mihai Claudiu Pui et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Neutrophil-to-Lymphocyte Ratio and Thrombocyte-to-Lymphocyte Ratio as a Predictor of Severe and Moderate/Mild Acute Respiratory Distress Syndrome Patients: Preliminary Results

Article Category: Research Article

Published Online: Jan 30, 2024

Page range: 49 - 55

Received: Jul 01, 2023

Accepted: Dec 08, 2023

DOI: https://doi.org/10.2478/jccm-2024-0005

Keywordsacute respiratory distress syndrome, neutrophil-to-lymphocyte ratio, thrombocyte-to-lymphocyte ratio

© 2024 Mihai Claudiu Pui et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Keywords
acute respiratory distress syndrome, neutrophil-to-lymphocyte ratio, thrombocyte-to-lymphocyte ratio