No relationship between red blood cell distribution width and microcirculatory alterations in septic patients

Article type: Research Article

Authors: Fontana, Vito^{a; b} | Spadaro, Savino^b | Bond, Ottavia^a | Cavicchi, Federica Zama^{a; b} | Annoni, Filippo^a | Donadello, Katia^a | Vincent, Jean-Louis^a | De Backer, Daniel^{a; c} | Taccone, Fabio Silvio^{a; *}

Affiliations: [a] Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium | [b] Department of Morphological Surgery and Experimental Medicine, Arcispedale Sant’Anna, Universitá di Ferrara, Ferrara, Italy | [c] Department of Intensive Care and Emergency, CHIREC Hospitals, Belgium

Correspondence: [*] Corresponding author: Dr. Fabio Silvio Taccone, Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles (ULB), Route de Lennik, 808, 1070 – Brussels, Belgium. Tel.: +322 555 5587; Fax: +322 555 4698; E-mail: [email protected].

Abstract: BACKGROUND: Increased red cell distribution width (RDW), a quantitative measure of erythrocyte size variability, has been associated with increased mortality in critically ill patients. METHODS: In this post-hoc analysis of prospectively collected data, we studied 122 septic patients with and without shock who had undergone sublingual microcirculatory assessment using Sidestream Dark Field (SDF) videomicroscopy. Patient demographics, comorbidities, the Acute Physiology and Chronic Health Evaluation (APACHE) II score on admission and the Sequential Organ Failure Assessment (SOFA) score on the day of the microcirculatory assessment were collected. The RDW was retrospectively collected on the day of the microcirculatory evaluation from the routine daily blood count analysis. RESULTS: Median patient age was 68[55–77] years, and median APACHE II and SOFA scores were 22[17–28] and 10[8–12], respectively; ICU mortality was 43%. On the day of the microcirculatory analysis, the median RDW was 13.8[12.8–15.5]% and was elevated (>13.4%) in 74 (61%) patients. There was no correlation between RDW and microcirculatory parameters (functional capillary density, r2 = 0.12; proportion of small perfused vessels, r2 = 0.17; mean flow index, r2 = 0.14). RDW was not related to disease severity, the presence of shock or survival. CONCLUSIONS: RDW is not associated with microcirculatory alterations or prognosis in septic patients.

Keywords: Red blood cell distribution width, microcirculation, sepsis and septic shock

DOI: 10.3233/CH-160154

Journal: Clinical Hemorheology and Microcirculation, vol. 66, no. 2, pp. 131-141, 2017