Effect of rectal ozone insufflation on clinical and laboratory outcomes in critically ill COVID-19 patients in the intensive care unit
Keywords:
COVID-19, ozone therapy, rectal ozone, intensive care, inflammationAbstract
Aim: To evaluate the effects of rectal ozone insufflation as an adjunctive therapy in critically ill patients hospitalized in the intensive care unit (ICU) with severe COVID-19 pneumonia.
Material and Methods: This single-blind, randomized, prospective clinical study included 60 adult patients with severe COVID-19 admitted to the ICU between May 15 and July 7, 2020. Patients were randomly assigned to either the rectal ozone insufflation (ROİ) group (n=30) or the control group (n=30). In addition to the standard COVID-19 treatment protocol, the ROİ group received rectal ozone insufflation (30 μg/250 mL) every 12 hours for 14 days. Primary outcomes included changes in C-reactive protein (CRP) levels, oxygen saturation, Glasgow Coma Scale (GCS), and Sequential Organ Failure Assessment (SOFA) scores. Secondary outcomes were duration of intubation, length of ICU and hospital stay, and mortality.
Results: Baseline demographic and clinical characteristics were comparable between groups. In the ROİ group, CRP levels significantly decreased at the end of treatment compared to baseline (p=0.001), whereas no significant change was observed in the control group. GCS scores significantly improved and SOFA scores significantly decreased in the ROİ group (p<0.05). The proportion of patients requiring intubation and overall mortality were significantly lower in the ROİ group compared to controls (p<0.05).
Conclusion: Rectal ozone insufflation as an adjunct to standard therapy may contribute to reduced inflammation, improved clinical scores, and lower mortality in critically ill COVID-19 patients. Larger multicenter studies are required to confirm these findings.
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