title: No relationship between red blood cell distribution width and microcirculatory alterations in septic patients.
abstract: BACKGROUND
  Increased red cell distribution width (RDW), a quantitative measure of erythrocyte size variability, has been associated with increased mortality in critically ill patients.
  
  
  METHODS
  In this post-hoc analysis of prospectively collected data, we studied 122 septic patients with and without shock who had undergone sublingual microcirculatory assessment using Sidestream Dark Field (SDF) videomicroscopy. Patient demographics, comorbidities, the Acute Physiology and Chronic Health Evaluation (APACHE) II score on admission and the Sequential Organ Failure Assessment (SOFA) score on the day of the microcirculatory assessment were collected. The RDW was retrospectively collected on the day of the microcirculatory evaluation from the routine daily blood count analysis.
  
  
  RESULTS
  Median patient age was 68[55-77] years, and median APACHE II and SOFA scores were 22[17-28] and 10[8-12], respectively; ICU mortality was 43%. On the day of the microcirculatory analysis, the median RDW was 13.8[12.8-15.5]% and was elevated (>13.4%) in 74 (61%) patients. There was no correlation between RDW and microcirculatory parameters (functional capillary density, r2 = 0.12; proportion of small perfused vessels, r2 = 0.17; mean flow index, r2 = 0.14). RDW was not related to disease severity, the presence of shock or survival.
  
  
  CONCLUSIONS
  RDW is not associated with microcirculatory alterations or prognosis in septic patients.
authors.affiliation: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.|Department of Morphological Surgery and Experimental Medicine, Arcispedale Sant'Anna, Universitá di Ferrara, Ferrara, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Fontana
authors.affiliation: Department of Morphological Surgery and Experimental Medicine, Arcispedale Sant'Anna, Universitá di Ferrara, Ferrara, Italy.
authors.forename: Savino
authors.initials: S
authors.lastname: Spadaro
authors.affiliation: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Ottavia
authors.initials: O
authors.lastname: Bond
authors.affiliation: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.|Department of Morphological Surgery and Experimental Medicine, Arcispedale Sant'Anna, Universitá di Ferrara, Ferrara, Italy.
authors.forename: Federica Zama
authors.initials: FZ
authors.lastname: Cavicchi
authors.affiliation: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Filippo
authors.initials: F
authors.lastname: Annoni
authors.affiliation: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Katia
authors.initials: K
authors.lastname: Donadello
authors.affiliation: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vincent
authors.affiliation: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.|Department of Intensive Care and Emergency, CHIREC Hospitals, Belgium.
authors.forename: Daniel
authors.initials: D
authors.lastname: De Backer
authors.affiliation: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Fabio Silvio
authors.initials: FS
authors.lastname: Taccone
mesh_terms: D000368:Aged; D004909:Erythrocyte Indices / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012772:Shock, Septic / Q000503:physiopathology*
keywords: Red blood cell distribution width; microcirculation; sepsis and septic shock