Can IL-33 and Endocan be New Markers for Retinopathy of Prematurity?

BACKGROUND: Retinopathy of Prematurity (ROP) is a pathophysiologic condition of the retina due to abnormal proliferation of retinal vessels. OBJECTIVE: The study aimed too ascertain the importance of vascular endothelial growth factor (VEGF), insulin-like growth factor-1 (IGF-1), interleukin-33 (IL-33) and endocan in the diagnosis and follow-up of ROP. METHODS: This prospective cohort study was conducted in the neonatal intensive care unit (NICU) of Health Science University, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey, between February 2017 and August 2018. Preterm infants (gestational age (GA) of ≤32 weeks and birth weight of ≤1500 gr), diagnosed ROP were included in the study. VEGF, IGF-1, IL-33 and endocan levels were evaluated in the cord blood and in the serum before and after treatment of infants in the ROP and control groups. RESULTS: A final number of 146 infants were included in the study. During the study period, 73 infants were identified as the ROP group, and 73 infants were allocated as the control group. In the ROP group, the cord blood VEGF value was higher than the control group (p <0.05). However, IGF-1 levels in the cord blood were lower in the ROP group than control (P<0.05). IL-33 and endocan values in the cord blood were similar in both control and ROP groups (p>0.05). Although serum levels of IL-33, VEGF and endocan were higher before laser treatment, these biomarkers decreased significantly after laser treatment (p <0.05). CONCLUSION: We determined that serum IL-33 and endocan levels might be suggested as sensitive novel markers for the prediction of severe ROP.

Anestesia para el tratamiento con láser de la retinopatía de la prematuridad / Anesthesia for the laser treatment of the premature retinopathy in the prematurit

La anestesia para el tratamiento con láser de la retinopatía de la prematuridad constituye un reto para el anestesiólogo, debido a las características anatómicas y fisiológicas de estos pacientes, al comportamiento farmacocinético y farmacodinámico de los anestésicos en ellos, y a las enfermedades que pueden tener asociadas. Por tal motivo se realizó una revisión de la literatura con el objetivo de mostrar las consideraciones anestésicas para el tratamiento con láser de dicha afección. Para ello se llevó a cabo una búsqueda sobre el tema en documentos impresos y electrónicos, así como en las siguientes bases de datos: Registro Cochrane Central, MEDLINE, EMBASE, Google. Se concluye que no existe una técnica anestésica ideal; la elección de una u otra depende del estado del paciente, de la experiencia del anestesiólogo, de la disponibilidad de recursos, del tiempo quirúrgico, así como del lugar donde se realice el proceder: quirófano o unidad de cuidados intensivos neonatales(AU)

The anesthesia for the laser treatment of the premature retinopathy is a challenge for the anesthesiologist due to the anatomic and physiologic characteristic of these patients, to the pharmacokinetic and pharmacodynamic behavior of the anesthetics in them and the diseases that can be associated to them. For that reason we review the literature with the objective of showing the anesthetic considerations for the laser treatment of that disease. We looked for the theme in books, printed documents and on line, and also in the following databases: Central Cochrane Register, MEDLINE, EMBASE, Google. We concluded that there is not an ideal anesthetic technique; selecting one of the other depends on the patient status, the anesthesiologist experience and the availability of resources, the surgical time, and also the place where the procedure is carry out: surgical center or neonatal intensive care unit(AU)

Anestesia para el tratamiento con láser de la retinopatía de la prematuridad / Anesthesia for the laser treatment of the premature retinopathy in the prematurit

La anestesia para el tratamiento con láser de la retinopatía de la prematuridad constituye un reto para el anestesiólogo, debido a las características anatómicas y fisiológicas de estos pacientes, al comportamiento farmacocinético y farmacodinámico de los anestésicos en ellos, y a las enfermedades que pueden tener asociadas. Por tal motivo se realizó una revisión de la literatura con el objetivo de mostrar las consideraciones anestésicas para el tratamiento con láser de dicha afección. Para ello se llevó a cabo una búsqueda sobre el tema en documentos impresos y electrónicos, así como en las siguientes bases de datos: Registro Cochrane Central, MEDLINE, EMBASE, Google. Se concluye que no existe una técnica anestésica ideal; la elección de una u otra depende del estado del paciente, de la experiencia del anestesiólogo, de la disponibilidad de recursos, del tiempo quirúrgico, así como del lugar donde se realice el proceder: quirófano o unidad de cuidados intensivos neonatales.

The anesthesia for the laser treatment of the premature retinopathy is a challenge for the anesthesiologist due to the anatomic and physiologic characteristic of these patients, to the pharmacokinetic and pharmacodynamic behavior of the anesthetics in them and the diseases that can be associated to them. For that reason we review the literature with the objective of showing the anesthetic considerations for the laser treatment of that disease. We looked for the theme in books, printed documents and on line, and also in the following databases: Central Cochrane Register, MEDLINE, EMBASE, Google. We concluded that there is not an ideal anesthetic technique; selecting one of the other depends on the patient status, the anesthesiologist experience and the availability of resources, the surgical time, and also the place where the procedure is carry out: surgical center or neonatal intensive care unit.

Nueva técnica anestésica en el tratamiento con láser diodo de la retinopatía del prematuro / New anaesthetic technique in diode laser treatment of retinopathy of prematurity

Introducción: La anestesia en prematuros es susceptible de tener múltiples complicaciones. Aunque la aplicación del láser diodo es menos dolorosa que la crioterapia, se debe conseguir una correcta inmovilización del paciente para un enfoque y una aplicación adecuados del mismo. Desde 1999 está protocolizada en el Hospital Infantil de Zaragoza una técnica anestésica que utiliza sedación con agentes inhalatorios asociada a anestesia tópica. Analizamos los resultados obtenidos en la utilización de dicha técnica. Material y método: Se incluyen 72 prematuros consecutivos tratados con láser por retinopatía del prematuro (ROP) utilizando la técnica anestésica de sedación inhalatoria y anestesia tópica. Se han recogido datos de los pacientes (edad gestacional, peso al nacer, edad posconcepcional en el momento del tratamiento inicial, patología sistémica asociada) y del acto quirúrgico (tiempo de duración y complicaciones intraoperatorias y postoperatorias). Resultados: Se produjeron complicaciones intraoperatorias en 12 casos (16,66 %). En 9 casos fueron autolimitadas y sólo 3 precisaron intubación orotraqueal (4,16 %). En 4 casos (5,55 %) se produjeron complicaciones postoperatorias en las 48 h posteriores al tratamiento. No se encontró relación estadísticamente significativa entre la presencia de complicaciones intraoperatorias y la media de edad gestacional y peso al nacer o la presencia de apneas, hemorragia intraventricular o ductus permeable. Se encontró relación estadísticamente significativa entre la presencia de complicaciones postoperatorias y la presencia de hemorragia intraventricular significativa. Conclusiones: La técnica anestésica con gases inhalatorios asociada a anestesia tópica es segura, con escasa proporción de complicaciones y cómoda para el cirujano (AU)

Introduction: Anaesthesia in premature infants can have many complications. Although the application of diode laser is less painful than cryotherapy, there has to be adequate immobilization of the patient to provide a correct focus of the spot. At Hospital Infantil de Zaragoza, the same standard anaesthestic technique has been applied since 1999, obtaining sedation with inhaled anaesthetic agents combined with topical anaesthesia. We analyse the results obtained on the application of this technique. Material and method: The study included 72 consecutive premature infants treated with diode laser for retinopathy of prematurity (ROP), using an anaesthestic technique combining inhalatory sedation and topical anaesthesia. The personal data of each patient was collected (gestational age, birth weight, postconceptional age at the time of initial treatment, associated systemic disorders) together with information related to the surgical intervention (duration, intraoperative and postoperative complications). Results: Intraoperative complications occurred in 12 cases (16.66 %). These were self-limited in 9 cases and only 3 cases required orotracheal intubation (4.16 %). Postoperative complications occurred in 4 cases (5.55 %) during the 48 h following treatment. No statistically significant relationship was found between the presence of intraoperative complications and the mean gestational age and birth weight, and the presence of apnoea, intraventricular haemorrhage or a permeable ductus. A statistically significant relationship was found between the presence of postoperative complications and significant intraventricular haemorrhage. Conclusions: This anaesthestic technique combining inhalatory gases and topical anaesthesia is safe, with few complications and comfortable for the surgeon (AU)

Laser diodo vermelho / Infrared diode laser with

Objetivo: analisar a técnica, indicaçöes e resultados da fotocoagulaçäo com laser diodo vermelho com oftalmoscopia indireta em portadores de retinopatia diabética proliferativa. Pacientes e métodos: estudo prospectivo da fotocoagulaçäo com laser diodo vermelho (810nm) indireto em 28 olhos de 21 pacientes com RDP com ou sem limitaçöes técnicas para o tratamento à lâmpada de fenda. Resultados: Treze olhos (46 por cento) completaram o tratamento e apresentaram estabilidade, com melhora da proliferaçäo. Quinze olhos (54 por cento) tiveram seu tratamento interrompido por intercorrências como evoluçäo de catarata, hemorragia vítrea clinicamente significativa, alteraçöes sistêmicas (como hipertensäo arterial näo controlada e cardiopatia que limitavam o uso do bloqueio ..