Correlation of red cell distribution width and serum lactate levels in critically ill pediatric patients

Sukewanti, Ni Made; Hartawan, I Nyoman Budi; Wati, Dyah Kanya; Suparyatha, Ida Bagus Gede; Ryalino, Christopher

doi:10.4103/bjoa.bjoa_28_20

Cited by 4 publications

(5 citation statements)

References 7 publications

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“…The current study found a statistically significant negative correlation between RDW and Hb level with p-value =0.007. This goes in run with Sukewanti et al study which found that RDW inversely correlated with hemoglobin with p-value=0.002 (12). This can be explained as the associated inflammation and sepsis among critically ill children leading to proinflammatory cytokines such as tumor necrosis factor α, interleukin 6, and interleukin 1B which could suppress RBC maturation and decrease the halflife of RBCs.…”

Section: Methodssupporting

confidence: 63%

“…Similarly, Ramby et al found that RDW was independently associated with PICU mortality with p-value=0.001 ( 11 ). Sukewanti et al study also found statistically significant higher RDW among non-survived critically ill children with pvalue =0.001 ( 12 ).…”

Section: Methodsmentioning

confidence: 84%

“…The current study found a statistically significant association between higher RDW group critically ill children and higher lactate with p-value =0.016. this goes in a run with Sukewanti et al study which was conducted on 68 critically ill children to evaluate the correlation between lactate level and RDW in critically ill children and found a statistically significant positive correlation between RDW and lactate level with p-value <0.001 (12). This can be explained as both RDW and lactate increase in similar conditions such as hypoxemia, inflammation, and altered tissue perfusion, which are found in various underlying diseases in critically ill patients, which supports that RDW might be used as a prognostic marker in critically ill patients (12).…”

Section: Methodsmentioning

confidence: 92%

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Prognostic Significance of Red Blood Cell Distribution width (RDW) in Critically ill Paediatric Patients at Sohag University Hospital

2023

JPTCP

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Background: RDW has been recently reported as a strong prognostic factor in several diseases of various organ systems , In critically ill children, it is crucial to assess the severity of illness and organ dysfunction.Aim: this study aimed to evaluate RDW as a marker for illness severity in critically ill paediatric patients Patients and methods: One hundred and eleven children, 55 males (49.5 %). were included in this cross-sectional hospital-based study. All critically ill paediatric patients, 1 month to 12 years of age, which were admitted to the Paediatric intermediate & Intensive Care Unit (PICU), at Sohag University Hospital, over six months period were included in the study, Investigations performed ; Complete Blood Count, Serum electrolytes, Blood gases, Coagulation profile , Liver and kidney functions, CRP, Serum lactate, serum fibrinogen, Blood urea nitrogen (BUN) and b-type natriuretic peptide. Observation for the patient if a mechanical ventilation and or inotropes were needed, and for the duration of hospital stay and for the outcome of the case. Calculation of critical illness scores including pediatric multiple organ dysfunction syndrome (PMODS), the pediatric risk of mortality (PRISM), pediatric sequential organ failure assessment (PSOFA) and pediatric logistic organ dysfunction-2 (PELOD-2). Results: Mortality among critically ill children was significantly associated with high RDW >16.9 with p-value <0.001.Critically ill children with low RDW <16.9 had significantly longer duration of PICU admission with p-value =0.015.Critically ill children with high RDW >16.9 had significantly lower GCS during their PICU admission with p-value<0.001. There was a statistically significant positive correlation between R DW level, PRISM III, SOFA, PLEOD II, and PMODS scores with pvalue <0.001. High RDW > 16.9 had a statistically significant predictor for survival of critically ill children with p-value <0.001.Univariate regression analysis shows that PRISM III, PSOFA, PLEOD II, PMODS and RDW% had statistically significant effect on PICU survival among critically ill children with p-value <0.001. Conclusion: Red blood cell distribution width ( RDW) is a good predictor of critical illness severity in pediatrics being significantly correlated with severity scores including SOFA, PLEOD II, and PRISM scores

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Section: Methodssupporting

confidence: 63%

Section: Methodsmentioning

confidence: 84%

Section: Methodsmentioning

confidence: 92%

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Prognostic Significance of Red Blood Cell Distribution width (RDW) in Critically ill Paediatric Patients at Sohag University Hospital

2023

JPTCP

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“…RDW was found to have a moderate correlation with lactate levels in critically ill pediatric patients [12]. Hyperlactatemia in sepsis is based on the theory that inadequate oxygen delivery causes tissue damage and anaerobic glycolysis, although recent evidence has revealed that a more complicated mechanism including adaptive metabolic processes, comorbidities, and drug/toxins all contribute to lactate accumulation [31].…”

Section: Discussionmentioning

confidence: 99%

“…Notably, few studies have compared the prognostic ability of RDW and lactate levels in patients with sepsis [12]. In addition, most RDW studies on patients with sepsis focused Diagnostics 2021, 11, 1474 2 of 9 on mortality risk, and rarely discussed other adverse outcomes, such as risk of septic shock, respiratory failure, or intensive care unit (ICU) admission.…”

Section: Introductionmentioning

confidence: 99%

Red Cell Distribution Width as a Prognostic Factor and Its Comparison with Lactate in Patients with Sepsis

Wang

Hsu

2021

Diagnostics

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Sepsis remains the leading cause of death in critically ill patients. Thus, regular measurement of lactate levels has been proposed in sepsis guidelines. Elevated red cell distribution width (RDW) is associated with mortality risk in patients with sepsis. This study aimed to investigate the association between RDW and the risk of other adverse outcomes in patients with sepsis and to compare the mortality discriminative ability between lactate and RDW levels. This is a single-centered, retrospective, case-control study that included 504 adult patients with sepsis in the emergency department between 1 January 2020 and 31 December 2020. Eligible patients were divided into normal (RDW ≤ 14.5%) and high (RDW > 14.5%) groups. The baseline characteristics and adverse outcomes were recorded and compared. Compared with the normal RDW group, the patients in the high RDW group had a significantly higher rate of ICU admission (48.8% vs. 32.4%, p = 0.03), septic shock (39.2% vs. 23.5%, p < 0.01), and 30-day in-hospital mortality (32.0% vs. 20.7%, p < 0.01). Furthermore, the RDW (area under curve (AUC) = 0.71) had superior mortality discriminative ability compared to lactate (AUC = 0.63) levels (p = 0.02). Clinicians could rely on this simple and rapid parameter for risk stratification to initiate prompt treatment for patients with sepsis.

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A Meta-analysis of the Utility of Red Cell Distribution Width as a Biomarker to Predict Outcomes in Pediatric Illness (PROSPERO CRD42020208777)

Murphy

Orgel

Koek

et al. 2021

J Pediatr Intensive Care

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Red cell distribution width (RDW) is an average of the variation in red blood cell (RBC) sizes reported on a complete blood count. An elevated RDW indicates a pathological process that is affecting erythropoiesis. Studies showed that as the severity of disease process increases, the RDW often increases as well. Particularly in resource-limited countries, RDW has been studied as an outcome predictor for conditions in a variety of disciplines and is offered as an adjunct monitoring tool that is cost effective, readily available, and indicative of pathological processes amenable to intervention. Particularly in pediatric critical care settings, RDW has been shown to be a reliable tool for surveillance of disease states such as sepsis. Despite the increased attention of RDW as a marker for disease outcome, collective evaluation on the utility of RDW as a marker for outcome in pediatric critical care settings is lacking. We offer a systematic review and meta-analysis of published studies to assess the ability of RDW to predict illness severity and mortality among pediatric critical care patients. Among eight studies of over 4,800 patients, we found over a two-fold increase in odds for mortality in critically ill children whose RDW was above 15.7%. This is the first systematic review of RDW being used to predict mortality in critically ill children and findings of this study may prompt early intervention in the pediatric critical care setting.

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Correlation of red cell distribution width and serum lactate levels in critically ill pediatric patients

Cited by 4 publications

References 7 publications

Prognostic Significance of Red Blood Cell Distribution width (RDW) in Critically ill Paediatric Patients at Sohag University Hospital

Prognostic Significance of Red Blood Cell Distribution width (RDW) in Critically ill Paediatric Patients at Sohag University Hospital

Red Cell Distribution Width as a Prognostic Factor and Its Comparison with Lactate in Patients with Sepsis

A Meta-analysis of the Utility of Red Cell Distribution Width as a Biomarker to Predict Outcomes in Pediatric Illness (PROSPERO CRD42020208777)

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