Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jun 7:14:12.
doi: 10.1186/s12950-017-0160-9. eCollection 2017.

Red cell distribution width (RDW) as a biomarker for respiratory failure in a pediatric ICU

Tom Schepens  1   2 , Jozef J De Dooy  2 , Walter Verbrugghe  2 , Philippe G Jorens  2
Affiliations

Red cell distribution width (RDW) as a biomarker for respiratory failure in a pediatric ICU

Tom Schepens et al. J Inflamm (Lond). .

Abstract

Background: The red cell distribution width (RDW) is a widely available, inexpensive, and highly reproducible test that reflects the range of the red cell sizes. Any process that releases reticulocytes in the circulation will result in an increase in RDW. Elevated RDW values are linked to worsened pulmonary function in the adult population. We performed a retrospective cohort study to describe the association between RDW and respiratory failure in critically ill children in a in a pediatric intensive care unit (PICU) in a tertiary university hospital.

Subjects: All patients admitted between January 2009 and June 2015 were considered eligible for inclusion.

Methods: Retrospective cohort study.

Results: In total, 960 patients were included in the cohort analysis. Of those patients, 149 (15.5%) had elevated RDW values. RDW on admission was associated with lower 28 day ventilator-free days. The highest quintile of RDW was associated with the need for mechanical ventilation, even when correcting for anaemia, age and Pediatric Risk of Mortality (PRISM) scores. In the subgroup of ventilated patients, RDW was associated with nadir PaO2/FiO2(P/F) ratios.

Conclusion: The RDW value on admission of our PICU patients is associated with a greater need for invasive mechanical ventilation, lower 28 day ventilator-free days and lower nadir P/F ratios in the patients with highest RDW values on admission. RDW may be a valuable, cheap and universally available, prognostic parameter for respiratory dysfunction in the PICU.

Keywords: Clinical trials; Critical care; Mechanical ventilation; Outcomes.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
mean nadir PaO2/FiO2 (P/F) ratio for each red cell distribution width (RDW) quintile
See this image and copyright information in PMC

References

    1. Bessman JD, Hurley EL, Groves MR. Nondiscrete heterogeneity of human erythrocytes: comparison of Coulter-principle flow cytometry and Soret-hemoglobinometry image analysis. Cytometry. 1983;3:292–295. doi: 10.1002/cyto.990030411. - DOI - PubMed
    1. Yčas JW, Horrow JC, Horne BD. Persistent increase in red cell size distribution width after acute diseases: A biomarker of hypoxemia? Clin Chim Acta. 2015;448:107–117. doi: 10.1016/j.cca.2015.05.021. - DOI - PubMed
    1. Weiss G, Goodnough LT. Anemia of Chronic Disease. N Engl J Med. 2005;35210:1011–1023. doi: 10.1056/NEJMra041809. - DOI - PubMed
    1. Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med. 2009;133:628–632. - PubMed
    1. Bazick HS, Chang D, Mahadevappa K, Gibbons FK, Christopher KB. Red cell distribution width and all-cause mortality in critically ill patients. Crit Care Med. 2011;39:1913–1921. doi: 10.1097/CCM.0b013e31821b85c6. - DOI - PMC - PubMed

LinkOut - more resources