RBC Distribution Width: Biomarker for Red Cell Dysfunction and Critical Illness Outcome?*

Said, Ahmed; Spinella, Philip C.; Hartman, Mary E.; Steffen, Katherine; Jackups, Ronald; Holubkov, Richard; Wallendorf, Mike; Doctor, Allan

doi:10.1097/pcc.0000000000001017

Cited by 54 publications

(28 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…13,21 Said et al also found a significant relation between admission RDW as well as relative RDW (calculated as the difference between the first day RDW and highest of the first seven days RDW divided by admission RDW) with mortality. 19 Similar to our study, Khanbabaee et al found a positive correlation between admission RDW and mortality but they could not find any association between ΔRDW and mortality. 13 Some studies suggest that the clearance of RBC from the circulation is well-balanced in healthy individuals but reduced in diseased states; as a result there is an increase in the number of smaller RBCs in the circulation which increases the RDW in diseased conditions.…”

Section: Discussionsupporting

confidence: 89%

“…6,18 Similarly several studies have been conducted on children in paediatric intensive care units which have also found an association of high RDW with mortality. 5,[13][14][15]19,20 However some other studies have found that there is no relation between high RDW and mortality in children. 13,21 Said et al also found a significant relation between admission RDW as well as relative RDW (calculated as the difference between the first day RDW and highest of the first seven days RDW divided by admission RDW) with mortality.…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

High Red Cell Distribution Width as a Biomarker of Mortality in Critically Ill Paediatric Patients

Gauchan¹,

Basnet²

2020

J. Nepal Paedtr. Soc.

View full text Add to dashboard Cite

Introduction: Red cell distribution width (RDW) is a frequently overlooked parameter in routine haematological reports. It is a simple and inexpensive test which has been found by many adult studies to be a prognostic indicator of mortality in intensive care units. The objective of this study was to see if high RDW could be used as a marker to predict mortality in critically ill children. Methods: This was a prospective observational study conducted in the paediatric intensive care unit (PICU) of a tertiary hospital of Western Nepal over a period of one year. Study subjects were selected by purposive sampling method. RDW at admission and relative change in RDW (ΔRDW) was compared to see if they had any role in predicting mortality in this group of children. Receiver operating curve analysis was plotted to find an optimal cut-off point to define high and low RDW and various outcome parameters were analysed. Results: Out of 131 children, there were 12 (9.1%) mortalities. Admission RDW was higher in the death group as compared to the survivor group (17 vs 14.6; p = 0.012). Similar finding was seen with ΔRDW (0.45 vs 0.00; p = 0.006). ΔRDW above the cut-off value of 0.15 was found to be associated with a generally more complicated course during hospitalisation as well as had more risk of mortality. Conclusions: Both RDW and ΔRDW above the cut-off value were found to be associated with mortality. In addition, high ΔRDW was also found to predict a more complicated course during hospitalisation.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 97%

High Red Cell Distribution Width as a Biomarker of Mortality in Critically Ill Paediatric Patients

Gauchan¹,

Basnet²

2020

J. Nepal Paedtr. Soc.

View full text Add to dashboard Cite

show abstract

“…Even though we could not find a significant correlation of RDW and deformability, as described by Patel et al (2013), there was a significant difference between groups in RDW, a parameter defining the degree of anisocytosis. Approximately 24% of Fontan patients in this study reached pathologic values (≥14.5%), which might be caused by disturbed erythropoiesis, shortened life span or early reticulocyte release (Said et al, 2017). This result is in agreement with previous findings (Tomkiewicz-Pajak et al, 2014).…”

Section: Discussionmentioning

confidence: 83%

Altered Hemorheology in Fontan Patients in Normoxia and After Acute Hypoxic Exercise

et al. 2019

View full text Add to dashboard Cite

BackgroundThe Fontan circulation is a unique palliation procedure for several congenital heart defects. Impaired exercise capacity has previously been demonstrated in these patients and also a higher risk for cardiopulmonary mortality. Hemorheology was shown to affect cardiopulmonary capacity and in turn to be affected by regular exercise and hypoxia but none of these have been investigated in Fontan patients so far. The aim of this study was to detect general differences in hemorheology in normoxia as well as possible altered hemorheological responses to hypoxia exposure and hypoxic exercise between Fontan patients and healthy controls.Methods and Findings26 Fontan patients and 20 healthy controls performed an acute exercise test (AET) on a bicycle ergometer under hypoxia with ambient 15.2% oxygen saturation (sO2). Blood samples were taken at rest in normoxia (T0), at rest in hypoxia (T1), after maximum exhaustion in hypoxia (T2), and after 50 min recovery in normoxia (T3). Hemorheological and blood parameters were investigated. Additionally, arterial stiffness was tested at T0. Red blood cell (RBC) deformability, NOx, erythropoietin (EPO) concentration, RBC count, hemoglobin (Hb) concentration and hematocrit (hct) were significantly increased in Fontan patients compared to controls. Same was observed for arterial stiffness. No changes were observed for RBC aggregation, fibrinogen concentration, free radical levels and vascular endothelial growth factor (VEGF). Hypoxia exposure did not change parameters, whereas exercise in hypoxia increased aggregation and hct significantly in both groups. Fontan patients showed significantly increased aggregation-disaggregation balance compared to controls.ConclusionAcute hypoxia exposure and exercise under hypoxia might have similar impact on hemorheology in Fontan patients and controls and was clinically well tolerated. Nevertheless, exercise alters aggregation and possibly hemodynamics which requires special attention in Fontan patients.

show abstract

“…Said et al, reported that both admission RBC distribution width and relative change in RBC distribution width correlated with mortality, fewer ICU-free days and ventilator-free days. 22 In ROC analyses of the relationship between RDW and mortality, the AUC for Admission RDW was 0.611 (95% CI, 0.076-0.218), whereas the AUC for PIM-2 score was 0.901 (95% CI, 0.908-1.166). Rambly et al, which did not exclude subjects who had received prior transfusions, reported that in all critically ill pediatric patients, RDW was independently associated with PICU mortality.…”

Section: Discussionmentioning

confidence: 96%

A study on the predictive value of red blood cell distribution width as a biomarker of outcome in paediatric critical illness

Rudrappa

Narasimhegowda

Gopal

2020

Int J Contemp Pediatr

View full text Add to dashboard Cite

Background: Red blood cell distribution width (RDW) is a simple, low cost measure, which is routinely reported as a standard component of complete hemogram. Several recent studies have found a positive association between RDW and risk of both morbidity and mortality in several diseases, particularly in critically ill adults.But, data regarding the outcome predictive utility of RDW in critically ill paediatric population is limited. The objective of the study was to determine the association between RDW and mortality and morbidity in paediatric critical illness.Methods: A cross sectional observational study was conducted from February 2019-May 2019 at Cheluvamba Hospital, Mysuru. 97 subjects admitted to Paediatric intensive care unit (PICU) were included in the study. Data regarding subject demographics, hospitalization characteristics, laboratory values and outcomes were collected.Results: A significant positive correlation was found between mortality among critically ill children and RDW measured within 24 hours of PICU admission (p=0.01) and peak RDW during the first 7 days of PICU stay (p=0.01). The relative change in RDW correlated significantly (p=0.01) with the number of intensive care unit (ICU) free days. Our subjects were divided into quartiles based on the admission RDW, subjects in the fourth quartile were found to have the highest mean Paediatric risk of mortality (PRISM III) score, Paediatric index of mortality (PIM 2) score and the least number of ICU free days. Area under the receiver operator curve (AUROC) for incidence of death was 0.706 for admission RDW,0.71 for peak RDW and 0.882 for PIM 2 score.Conclusions: Our data demonstrates that RDW at the time of PICU admission could serve as a cost-effective marker for early identification of critically ill paediatric population who are at risk for adverse outcomes.

show abstract

RBC Distribution Width: Biomarker for Red Cell Dysfunction and Critical Illness Outcome?*

Cited by 54 publications

References 36 publications

High Red Cell Distribution Width as a Biomarker of Mortality in Critically Ill Paediatric Patients

High Red Cell Distribution Width as a Biomarker of Mortality in Critically Ill Paediatric Patients

Altered Hemorheology in Fontan Patients in Normoxia and After Acute Hypoxic Exercise

A study on the predictive value of red blood cell distribution width as a biomarker of outcome in paediatric critical illness

Contact Info

Product

Resources

About