Reviewing the value of leukocytes cell population data (CPD) in the management of sepsis

Urrechaga, Eloísa

doi:10.21037/atm-19-3173

Cited by 42 publications

(37 citation statements)

References 51 publications

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“…Among all the biomarkers investigated, the parameters belonging to the Complete Blood Count (CBC) have emerged as precious tools providing a wealth of information on individual health statuses. In addition to the traditional CBC parameters, the new generation of haematological analysers provide several parameters, called cell population data (CPD), which reflect the morphological and functional characteristics of leukocytes [ 8 ]. The monocyte distribution width (MDW) is a CPD parameter automatically generated by last-generation DxH 900 haematology analysers (Beckman Coulter, Inc., Brea, CA, USA).…”

Section: Introductionmentioning

confidence: 99%

Independent Validation of Sepsis Index for Sepsis Screening in the Emergency Department

et al. 2021

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(1) Background: The early detection of sepsis is still challenging, and there is an urgent need for biomarkers that could identify patients at a high risk of developing it. We recently developed an index, namely the Sepsis Index (SI), based on the combination of two CBC parameters: monocyte distribution width (MDW) and mean monocyte volume (MMV). In this study, we sought to independently validate the performance of SI as a tool for the early detection of patients at a high risk of sepsis in the Emergency Department (ED). (2) Methods: We enrolled all consecutive patients attending the ED with a request of the CBC. MDW and MMV were measured on samples collected in K3-EDTA tubes on the UniCel DxH 900 haematology analyser. SI was calculated based on the MDW and MMV. (3) Results: We enrolled a total of 703 patients stratified into four subgroups according to the Sepsis-2 criteria: control (498), infection (105), SIRS (52) and sepsis (48). The sepsis subgroup displayed the highest MDW (median 27.5, IQR 24.6–32.9) and SI (median 1.15, IQR 1.05–1.29) values. The ROC curve analysis for the prediction of sepsis showed a good and comparable diagnostic accuracy of the MDW and SI. However, the SI displayed an increased specificity, positive predictive value and positive likelihood ratio in comparison to MDW alone. (4) Conclusions: SI improves the diagnostic accuracy of MDW for sepsis screening.

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Section: Introductionmentioning

confidence: 99%

Independent Validation of Sepsis Index for Sepsis Screening in the Emergency Department

et al. 2021

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“…A new generation of hematological analyzers has recently enabled clinicians to obtain faster and even more accurate morphological information from the complete blood count ( 34 ). In particular, leukocyte-derived parameters, named Cell Population Data, are emerging as potentially useful parameters for early sepsis diagnosis in adult patients ( 35 ).…”

Section: Discussionmentioning

confidence: 99%

“…CPD were obtained with an automated hematological analyzer (Sysmex XN 9000®, Sysmex Corporation, Kobe, Japan), which uses flow cytometry to measure individual cells. Activation of neutrophils and monocytes are detected in real-time, in an accurate and reproducible way ( 35 ). In the Sysmex XN analyzers, the leukocyte differential channel discriminates the leukocytes, while the signals are plotted in a scattergram.…”

Section: Methodsmentioning

confidence: 99%

“…In the Sysmex XN analyzers, the leukocyte differential channel discriminates the leukocytes, while the signals are plotted in a scattergram. In brief, the differential leucocyte count is based on criteria of cellular granularity (side scatter light), cell volume and shape (forward scatter light) and nucleic acid/protein content of cells (fluorescent light intensity), by preincubation with unique surfactant reagents and fluorescence staining ( 30 , 35 ). These optical signals of leukocyte differential are presented in the three axes of the white blood cells differential fluorescence (WDF) channel scattergram.…”

Section: Methodsmentioning

confidence: 99%

“…The variation of CPD in response to various stimuli (e.g., infections) was found to provide rapid information on leucocytes activation, offering a new method for improving early diagnosis of sepsis (27)(28)(29)(30)(31). Notably, CPD parameters can be automatically obtained by a new generation of hematological analyzers (e.g., Sysmex XN) during standard differential cell blood count analysis, obviating the need for additional blood tests and added costs (31)(32)(33)(34)(35)(36). The CPD analysis method is therefore characterized by simplicity, accessibility, and speed.…”

Section: Introductionmentioning

confidence: 99%

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Cell Population Data (CPD) for Early Recognition of Sepsis and Septic Shock in Children: A Pilot Study

et al. 2021

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Objectives: Innovative Cell Population Data (CPD) have been used as early biomarkers for diagnosing sepsis in adults. We assessed the usefulness of CPD in pediatric patients with sepsis/septic shock, in terms of early recognition and outcome prediction. We revised 54 patients (0–15 y) admitted to our Pediatric Intensive Care Unit (PICU) for sepsis/septic shock during a 4-year period. Twenty-eight patients were excluded, 26 septic patients were enrolled (G1). Forty children admitted for elective surgery served as controls (G2). Data on five selected CPD parameters, namely neutrophils fluorescence intensity (NE-SFL), monocytes cells complexity (MO-X), monocytes fluorescence intensity (MO-Y), monocytes complexity and width of dispersion of events measured (MO-WX), and monocytes cells size and width dispersion (MO-WZ), were obtained at time of PICU admission (t0) by a hematological analyzer (Sysmex XN 9000®). As the primary outcome we evaluated the relevance of CPD for diagnosing sepsis/septic shock on PICU admission. Furthermore, we investigated if CPD at t0 were correlated with C-reactive protein (CRP), patient survival, or complicated sepsis course.Results: On PICU admission (t0), NE-SFL, MO-WX, and MO-Y were higher in sepsis/septic shock patients compared to controls. NE-SFL values were correlated with CRP values in G1 patients (r = 0.83). None of the five CPD parameters was correlated with survival or complicated sepsis course.Conclusion: We found higher values of NE-SFL, MO-WX, and MO-Y in children with sepsis/septic shock upon PICU admission. These parameters may be a promising adjunct for early sepsis diagnosis in pediatric populations. Larger, prospective studies are needed to confirm our preliminary observations.

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Leukocyte cell population data from the blood cell analyzer as a predictive marker for severity of acute pancreatitis

Wang

Zhou

et al. 2021

Clinical Laboratory Analysis

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Background The prediction for severe acute pancreatitis (SAP) is the key to give timely targeted treatment. Leukocyte cell population data (CPD) have been widely applied in early prediction and diagnosis of many diseases, but their predictive ability for SAP remains unexplored. We aim to testify whether CPD could be an indicator of AP severity in the early stage of the disease. Methods The prospective observational study was conducted in the emergency department ward of a territory hospital in Shanghai. The enrolled AP patients should meet 2012 Atlanta guideline. Results Totally, 103 AP patients and 62 healthy controls were enrolled and patients were classified into mild AP (n = 30), moderate SAP (n = 42), and SAP (n = 31). Forty‐two CPD parameters were examined in first 3 days of admission. Four CPD parameters were highest in SAP on admission and were constantly different among 3 groups during first 3 days of hospital stay. Eighteen CPD parameters were found correlated with the occurrence of SAP. Stepwise multivariate logistic regression analysis identified a scoring system of 4 parameters (SD_LALS_NE, MN_LALS_LY, SD_LMALS_MO, and SD_AL2_MO) with a sensitivity of 96.8%, specificity of 65.3%, and AUC of 0.87 for diagnostic accuracy on early identification of SAP. AUC of this scoring system was comparable with MCTSI, SOFA, APACHE II, MMS, BISAP, or biomarkers as CRP, PCT, and WBC in prediction of SAP and ICU transfer or death. Conclusions Several leukocyte CPD parameters have been identified different among MAP, MSAP, and SAP. They might be ultimately incorporated into a predictive system marker for severity of AP.

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Reviewing the value of leukocytes cell population data (CPD) in the management of sepsis

Cited by 42 publications

References 51 publications

Independent Validation of Sepsis Index for Sepsis Screening in the Emergency Department

Independent Validation of Sepsis Index for Sepsis Screening in the Emergency Department

Cell Population Data (CPD) for Early Recognition of Sepsis and Septic Shock in Children: A Pilot Study

Leukocyte cell population data from the blood cell analyzer as a predictive marker for severity of acute pancreatitis

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