Carrillo ER, Contreras DV, Carrillo CLD, Carrillo CJR

Language: English
References: 12
Page: 20-25
PDF size: 64.85 Kb.

ABSTRACT

The role of leucocytes in inflammatory response is well known, nevertheless the rheologic changes of red blood cells (RBC) and their physiopathological role during inflammation are not completely understood. Previous studies have founded important alterations in RBC shape and functional disturbances during sepsis and inflammation. This has brought to discussion the hypothesis that RBC alterations during shock and sepsis may contribute to multiple organ dysfunction syndrome (MODS). The RBC distribution width (RBC-DW) is and indirect measurement of the variation of RBC size. Our objective was to study the variations of RBC distribution width in patients with sepsis admitted to a medical/surgical ICU (MS-ICU).
Material and methods: Two groups of patients admitted to the MS-ICU were included. One of patients with sepsis, severe sepsis and septic shock, the second one patients admitted without sepsis. There was also a group of healthy blood donors as control group. The variables studied included: RBC-DW, APACHE II and SOFA scores. The RBC-DW was measured with a computerized system (Sysmex xt2000-i) in a sample of whole blood (7.5 mL) anticoagulated with acid etylenediaminotetracetic (EDTA) during the first 24 hours of admission. The inclusion criteria were: Patients between 18 and 60 years old and patients with sepsis criteria.
Results: There were 184 patients included with the following distribution: Septic group 58, without sepsis group 63 and control group 64 patients. The mean age in the septic group was 48 ± 11 years, without sepsis group 46 ± 8 years and control group 43 ± 6 years. The mean of RBC-DW in the sepsis group was 18.23 ± 2.01 vs 14.03 ± 1.36 (p › 0.05; t 1.47, IC 95%) in the without sepsis group and 12 ± 0.27 (p ‹ 0.05; t 3.580, IC 95%) in the control group. The means severity scores in the sepsis group were APACHE II 17.52 ± 8.51 and SOFA 9.47 ± 5.43; in the without sepsis group APACHE II 6.10 ± 7.01 and SOFA 2.44 ± 3.76.
Conclusions: The RBC-DW is higher in septic patients compared with patients without sepsis and healthy subjects. A relation between RBC-DW and higher morphologic alterations in RBC in patients with sepsis is probable. This measure is also statistically higher in patients with the highest SOFA values, but not APACHE II. We need to study a bigger population to acutely describe an association between this variables and RBC-DW. The relationship between RBC-DW and severity assessments scores has to be defined with future studies.

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