title: The relationship between hemorheological parameters and mortality in critically ill patients with and without sepsis.
abstract: OBJECTIVE
  The prognostic scoring systems for mortality of intensive care patients estimate clinical outcome using several physiological and biochemical parameters. In altered hemodynamic conditions of critically ill patients, hemorheological variables may play a significant role in appropriate tissue perfusion. We investigated if hemorheological parameters are altered in critical status and if they could be markers of mortality.
  
  
  METHODS
  112 patients (67.8 ± 12 years, 58 males, 54 females) treated in intensive care unit with different non-surgical diseases were investigated. Routine laboratory parameters and prognostic scores were determined and hemorheological variables (hematocrit, plasma and whole blood viscosity, red blood cell aggregation and deformability) were measured on the 1st and the 2nd day after admission.
  
  
  RESULTS
  ICU scores predicted 35.2-41.3% mortality rate, real mortality in intensive care unit was 37.5%, while 30-day mortality was 46.6%. Whole blood viscosity (WBV) and red blood cell (RBC) deformability were lower, red blood cell aggregation was higher in septic than in nonseptic patients (p < 0.05). In septic patients calcium was increased, osmolality was decreased, while in nonseptic patients WBV and RBC aggregation were higher in nonsurvivors compared to survivors (p < 0.05). Worsening of RBC deformability from day 1 to day 2 predicted higher mortality (p < 0.05).
  
  
  CONCLUSIONS
  Calcium and osmolality level were associated with outcome in sepsis. Whole blood viscosity, red blood cell aggregation and change in red blood cell deformability could predict mortality in nonseptic patients and they may add prognostic information over the ICU scores. Further investigations are needed to evaluate the benefit of our findings in clinical practice.
authors.forename: Kinga
authors.initials: K
authors.lastname: Totsimon
authors.forename: Katalin
authors.initials: K
authors.lastname: Biro
authors.forename: Zsofia Eszter
authors.initials: ZE
authors.lastname: Szabo
authors.forename: Kalman
authors.initials: K
authors.lastname: Toth
authors.forename: Peter
authors.initials: P
authors.lastname: Kenyeres
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Marton
mesh_terms: D000368:Aged; D016638:Critical Illness / Q000401:mortality*; D004903:Erythrocyte Aggregation; D004907:Erythrocyte Deformability; D005260:Female; D018056:Hemorheology; D006801:Humans; D008297:Male; D011379:Prognosis; D018805:Sepsis / Q000097:blood* / Q000401:mortality*
keywords: Critically ill patients; red blood cell aggregation; red blood cell deformability; sepsis; viscosity