الفهرس | Only 14 pages are availabe for public view |
Abstract Sepsis and septic shock are increasing in incidence, and the mortality rate is still elevated. The prediction of outcome for patients with sepsis may facilitate more aggressive interventions, and many prognostic factors such as age, sex, comorbidities, biomarkers, and severity of illness have been reported to be associated with outcome. The aim of our study is to detect the value of RDW in patients with sepsis and septic shock and clarifying their effects on the outcome and resolution of septic shock in ICU. RDW is a measure of the variability in the size of circulating red blood cells and is a part of the complete blood count (CBC) panel. Recently RDW has been associated with morbidity and mortality in several diseases, e.g. heart failure. RDW is a new promising cheap and readily available biomarker that can aid the diagnosis of patients with sepsis with high specificity and sensitivity. The mechanism of elevated RDW in these patients is not known, but it has been suggested that inflammatory process is associated with elevated RDW. Oxidative stress and neurohormonal response may also be a contributing factors leading to higher RDW. In our prospective study 46 patients admitted to the intensive care unit of Damanhour Medical National Institute with signs and symptoms of septic shock were included and assigned into 2 groups (23 patients for each group): group A is for Survive patients and group B for died patients for assessment of RDW. We found that Survive patients on admission RDW value ranged from 11.8-17.8 with mean value 141.65 and at end of follow up ranged from 11-12.5 with mean value 11.450.48. Died patient on admission ranged from 11-15 with mean value 13.341.0 and at end of follow up ranged from 12-15 with mean value 14.350.76. On admission, there was statistically significant difference in between survives and died patients (p2 <0.005). At the end of follow up, RDW showed statistically significant higher values in died patients than survive patients (p2<0.005).In survive patients group, RDW showed statistically significant lower values at end of follow up compared with on admission (p1<0.005). |