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. 2014 Mar;28(2):130-5.
doi: 10.1002/jcla.21656. Epub 2014 Jan 6.

Novel parameters of extended complete blood cell count under fluorescence flow cytometry in patients with sepsis

Borros M Arneth  1 , Maximilian Ragaller, Kathleen Hommel, Oliver Tiebel, Mario Menschikowski, Gabriele Siegert
Affiliations

Novel parameters of extended complete blood cell count under fluorescence flow cytometry in patients with sepsis

Borros M Arneth et al. J Clin Lab Anal. 2014 Mar.

Abstract

Background: We first describe a patient who developed urosepsis from an ordinary urinary tract infection. In this case, the new hematological parameters of immature leukocytes, that is, the high-fluorescence lymphocyte cell (HFLC) and immature granulocyte (IG) counts peaked early, whereas the established infection parameters, that is, C-reactive protein (CRP) and total white blood cell count showed less dynamic regarding infection and therapy.

Methods: To investigate this phenomenon in greater detail, the novel parameters HFLC and IG counts are investigated retrospectively in a cohort of 38 patients who were admitted to the anesthesia intensive care unit. Three groups of patients have been analyzed and compared: patients without signs of infection, patients with limited infections, and patients with sepsis. Data were collected with a Sysmex XE-5000 hematological analyzer.

Results: In patients (n = 22) without any signs of infection, both values are very low. In patients with limited local infections (n = 10), moderate elevations of the IG and HFLC counts are seen. In patients with sepsis (n = 6), the IG and HFLC counts are significantly higher.

Conclusion: The total IG count seems to be useful for distinguishing a septic patient from a nonseptic (P < 0.004). Hematological parameters have the advantage of being measured easily during routine blood cell analysis.

Keywords: anesthesiology; flow cytometry; hematology.

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Figures

Figure 1
Figure 1
Case study of a patient who developed urosepsis from an ordinary urinary tract infection. Although the conventional parameters CRP (∼200 mg/l), leukocytes (∼10 109/l), and PCT (∼1 ng/l) did not show any change in response to the onset of sepsis, the new parameters derived from blood cell counts, percentage of HFLC and IG, were significantly increased from day 7 onwards and dynamically reacted in response to antibiotic therapy. CRP in milligram per liter reference range <0.5mg/l; PCT in nanogram per milliliter reference range <0.5 ng/l; leukocytes in 109/l, reference range 3.8–9.8·109/l.
Figure 2
Figure 2
This figure gives the key findings and demonstrates it in absolute cell counts. Differences in absolute amounts of HFLCs and absolute amounts of IGs among patients with no infections (n, N = 22), patients with local infections (i, N = 10), and patients with sepsis (s, N = 6). All of the patients with sepsis had elevated IG‐cell counts, and two septic patients had increased HFLC counts. *Significant difference based on the unpaired t‐test (P < 0.01).
See this image and copyright information in PMC

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