Influence of K2-EDTA and K3-EDTA tubes for monocyte distribution width measurement

Lopez-Molina, Maria Isabel; Ganduxé, X. Tejedor; Iribarren, A. Martínez; Espinosa, Marcelo; Torres, S.; Sala, María; Fernández, C. Hernández; Abadía, Carlos Dolz; Llopis, Marta; Morales‐Indiano, Cristian

doi:10.1016/j.cca.2019.03.819

Cited by 4 publications

(2 citation statements)

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“…This could be due to the type and clinical status of hospitalized patients, as well as to technical issues. Among the latter, it is worth pinpointing that we utilized K3EDTA anticoagulant tubes for CBC and MDW determinations, while FDA approved MDW measures using K2EDTA whole-blood venous samples [30]. However, in addition to our best statistical cut-off of 22, we found that a lower cut off of 20 improved the negative predictive value of MDW for sepsis and might therefore be more helpful for real practice purposes.…”

Section: Discussionmentioning

confidence: 86%

Comparison of Monocyte Distribution Width (MDW) and Procalcitonin for early recognition of sepsis

Polilli¹,

Sozio²,

Frattari³

et al. 2020

PLoS ONE

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We carried out a prospective observational study to evaluate whether Monocyte Distribution Width (MDW) may play a role in identifying patients with sepsis in comparison with Procalcitonin (PCT). We prospectively enrolled all consecutive patients hospitalized at the Infectious Diseases Unit of Pescara General Hospital for bacterial infection or sepsis. MDW values were collected for all patients. Clinical characteristics, demographic data, past and present medical history, microbiological results, PCT, as well as neutrophil and monocytes indices at entry were compared in the 2 groups. Two-hundred-sixty patients were enrolled, 63.5% males, aged 59.1±19.5 years. Sepsis was diagnosed in 105 (40.4%); in 60 (57.1%) at least 1 microorganism was isolated from blood cultures. In multivariate models, MDW as a continuous variable (OR:1.57 for each unit increase; 95%CI: 1.31-1.87, p<0.001) and PCT>1 ng/ mL (OR: 48.5; 95%CI: 14.7-160.1, p<0.001) were independently associated with sepsis. Statistical best cut points associated with sepsis were 22.0 for MDW and 1.0 ng/mL for PCT whereas MDW values<20 were invariably associated with negative blood cultures. At ROC curve analysis, the AUC of MDW (0.87) was nearly overlapping that of PCT (0.88). Our data suggest that incorporating MDW within current routine WBC counts and indices may be of remarkable use for detection of sepsis. Further research is warranted.

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Section: Discussionmentioning

confidence: 86%

Comparison of Monocyte Distribution Width (MDW) and Procalcitonin for early recognition of sepsis

Polilli¹,

Sozio²,

Frattari³

et al. 2020

PLoS ONE

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“… 30 , 31 , 33 , 37 , 42 , 69 This may be due to the type and clinical condition of the patients admitted as well as technical problems. The FDA 70 approved the use of whole blood vein samples of K2EDTA to detect MDW, and many laboratories use K3EDTA, which has been shown to yield higher values for MDW than K2EDTA. 71 The influence of anticoagulants has been reported by the manufacturer, with a 1.5 offset between K2 and K3.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and Prognostic Value of Monocyte Distribution Width in Sepsis

Wu¹,

Li²,

Luo³

2022

JIR

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Monocyte distribution width (MDW) is a blood monocyte morphological parameter that can be easily detected by an automated hemocyte analyzer and can provide clinicians with important information about cell volume variability in peripheral blood monocyte populations. The United States’ Food and Drug Administration and Conformite Europeenne have both been cleared for their clinical application in the detection of sepsis and developing sepsis in adult patients in the emergency department (ED). Recently, MDW has been found to have an early diagnosis and predictive value for sepsis in neonates and COVID-19 patients. Here, we summarize the findings of the studies investigating the clinical application of MDW in sepsis. Under different stimuli, especially in infectious diseases, the activation of innate immunity is the host’s first defense mechanism, and the change in monocyte volume is considered an early indicator reflecting the state of activation of innate immunity. Pivotal study data from a large multicenter patient cohort showed that abnormal MDW at presentation increases the odds of sepsis, considering the combination of MDW and White Blood Cell Count (WBC) as part of a standard sepsis assessment protocol for ED, which may increase the sensitivity and specificity of sepsis diagnosis. Meanwhile, MDW shares a diagnostic performance comparable to that of conventional biomarkers (C-reactive protein and procalcitonin) in sepsis. In addition, some evidence suggests that increased MDW, both in adults and neonates, may be associated with unfavorable short- and long-term outcomes, which indicates its prognostic value in sepsis. Taken together, MDW is a parameter of increased morphological variability of monocytes in response to infection, and numerous studies have shown that MDW could be used as a valuable diagnostic and prognostic index in patients with sepsis or suspected sepsis.

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