Toward a Blood-Borne Biomarker of Chronic Hypoxemia: Red Cell Distribution Width and Respiratory Disease

Ycas, J.

doi:10.1016/bs.acc.2017.06.002

Cited by 34 publications

(26 citation statements)

References 224 publications

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“…Moreover, inflammation can retard the maturation of red blood cells, causing an upregulation of reticulocytosis and the release of a large number of reticulocytes into the peripheral circulation, leading to the increase of RDW 28,29 . Third, in patients with mechanical ventilation and acute lung injury, oxidative stress presents to reactive active oxygen free radicals which can curtail the lifespan of red blood cells, thus promoting the release of young cells into the circulation 30 . Renal failures, hyperglycemia and vitamin D3 deficiency have also been suggested as factors linking RDW to poor clinical outcomes 6 .…”

Section: Discussionmentioning

confidence: 99%

Association between red blood cell distribution width and long-term mortality in acute respiratory failure patients

Zhang

Wang²,

Wang

et al. 2020

Sci Rep

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The red cell distribution width (RDW) has been reported to be positively correlated with short-term mortality of pulmonary disease in adults. However, it is not clear whether RDW was associated with the long-term prognosis for acute respiratory failure (ARF). Thus, an analysis was conducted to evaluate the association between RDW and 3-year mortality of patients by the Cox regression analysis, generalized additives models, subgroup analysis and Kaplan–Meier analysis. A total of 2999 patients who were first admitted to hospital with ARF were extracted from the Medical Information Mart for Intensive Care III database (MIMIC-III). The Cox regression analysis showed that the high RDW was associated with 3-year mortality (HR 1.10, 95% CI 1.07, 1.12, P < 0.0001) after adjusting for age, gender, ethnicity and even co-morbid conditions. The ROC curve illustrated the AUC of RDW was 0.651 (95% CI 0.631, 0.670) for prediction of 3-year mortality. Therefore, there is an association between the RDW and survival time of 3 years follow-up, particularly a high RDW on admission was associated with an increased risk of long-term mortality in patients with ARF. RDW may provide an alternative indicator to predict the prognosis and disease progression and more it is easy to get.

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Section: Discussionmentioning

confidence: 99%

Association between red blood cell distribution width and long-term mortality in acute respiratory failure patients

Zhang

Wang²,

Wang

et al. 2020

Sci Rep

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“…A comprehensive review of diseases affecting the respiratory tract showed that the long-term response of RDW to hypoxia may be related to the strong response of endogenous erythropoietin to hypoxia, and hypoxemia (as SaO 2 ) is correlated with RDW in PE and COPD [ 23 ]. However, this has not been extensively studied.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Red Blood Cell Distribution Width in Chronic Obstructive Pulmonary Disease Patients with Pulmonary Embolism

Wang

Wan

Qing

et al. 2020

Analytical Cellular Pathology

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Purpose. This study is aimed at investigating the relationship between red cell distribution width (RDW) and chronic obstructive pulmonary disease (COPD) patients with pulmonary embolism (PE). Methods. We conducted a retrospective study enrolling a total of 125 patients from January 2013 to December 2019. The study group consisted of 40 COPD patients with PE, and the control group had 85 COPD patients without PE. Clinical data including demographic characteristics, comorbidities, and results of imaging examinations and laboratory tests were recorded. Blood biomarkers, including red blood cell distribution width standard deviation (RDW-SD), red blood cell distribution width coefficient of variation (RDW-CV), and D-Dimer, were included. Results. RDW-SD and RDW-CV were higher in the COPD patients with the PE group (p<0.001). A higher RDW-SD led to a significantly increased risk of PE than a lower RDW-SD (adjusted odds ratio (OR): 1.188; 95% confidence interval (CI): 1.048-1.348). The area under the curve (AUC) of RDW-SD used for predicting PE was 0.737. Using 44.55 as the cutoff value of RDW-SD, the sensitivity was 80% and the specificity was 64.7%. The prediction accuracy of RDW-SD combined with D-Dimer (AUC=0.897) was higher than that of RDW-SD or D-Dimer alone. The optimal cutoff value of RDW-SD+D-Dimer for predicting PE was 0.266, which generated a sensitivity of 87.5% and specificity of 83.5%. Conclusion. RDW is significantly increased in COPD patients with PE and may thus be useful in predicting the occurrence of PE in patients with COPD.

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“…The mechanism linking RDW to outcomes in different diseases is unknown. Endogenous erythropoietin responds strongly to hypoxaemia, and this molecule could potentially mediate an increase of the RDW response to low oxygenation due the unusual formation of large red blood cells [20]. Respiratory event-associated desaturations are seen more frequently in adults than in children, and the intermittent hypoxia is the hallmark feature and the most important pathophysiological pathway of OSA.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Red cell distribution width: a new tool for the severity prediction of sleep apnoea syndrome in children

et al. 2020

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IntroductionRed cell distribution width (RDW) is a parameter included in the complete blood count which informs about the size of the circulating red blood cell population and its distribution. In adults, an increase in RDW was shown to be associated both with obstructive sleep apnoea (OSA) and with an increase in cardiovascular mortality. The aim of this study was to determine whether RDW is a potential biomarker for screening children with moderate–severe OSA.MethodsAn observational study in snoring patients was performed. All patients underwent a sleep study and were classified either as simple snorers (apnoea–hypopnoea index (AHI) <1 event·h−1) or as patients with OSA (mild AHI ≥1 to <5 events·h−1; moderate–severe AHI ≥5 events·h−1). Blood analyses (complete blood count and C-reactive protein) were performed for every individual.ResultsA total of 175 individuals were recruited. The mean age was 8.3±3.6 years. Correlation studies between RDW and several sleep-related parameters showed negative significant associations with minimum oxygen saturation, and positive significant associations with oxygen desaturation index (≥3% and ≥4%), AHI and the arousal index. A predictive model for paediatric severe OSA (AHI ≥5 events·h−1) was found based on mean corpuscular haemoglobin concentration (MCHC) <34.9 g·dL−1 and RDW >13.1% values, adjusting for body mass index z-score and age (area under the curve 0.657; p=0.004). In addition, differences were found in eosinophil count and C-reactive protein concentrations among the three subgroups.ConclusionsIn children, RDW stands out as a biomarker associated with the severity of OSA. The use of RDW and MCHC could be a simple but useful tool for the severity prediction of paediatric OSA in snoring patients.

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Toward a Blood-Borne Biomarker of Chronic Hypoxemia: Red Cell Distribution Width and Respiratory Disease

Cited by 34 publications

References 224 publications

Association between red blood cell distribution width and long-term mortality in acute respiratory failure patients

Association between red blood cell distribution width and long-term mortality in acute respiratory failure patients

Predictive Value of Red Blood Cell Distribution Width in Chronic Obstructive Pulmonary Disease Patients with Pulmonary Embolism

Red cell distribution width: a new tool for the severity prediction of sleep apnoea syndrome in children

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