Re-evaluation of Established Risk Scores by Measurement of Nucleated Red Blood Cells in Blood of Surgical Intensive Care Patients

AbstractThe detection of nucleated red blood cells (NRBCs) in blood of patients suffering from a variety of severe diseases is known to be highly associated with increased mortality. Blood analyzers to routinely measure NRBC concentrations are now available. However, the diagnostic and prognostic significance of this parameter for intensive care patients has not been evaluated. Using a Sysmex XE-2100 analyzer, NRBC concentrations were determined in blood samples from 421 patients treated in intensive care units (general and accident surgery, cardiothoracic surgery, and internal medicine) of a university hospital. NRBCs were found at least once in 19.2% of all patients. The mortality of NRBC-positive patients (n = 81) was 42.0% (n = 34); this was significantly higher (p < 0.001) than the mortality of NRBC-negative patients (5.9%, n = 340). The NRBC concentration was 115 ± 4 × 10

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Nucleated red blood cells in the blood of medical intensive care patients indicate increased mortality risk: a prospective cohort study

Critical Care ◽

10.1186/cc5932 ◽

2007 ◽

Vol 11 (3) ◽

pp. R62 ◽

Cited By ~ 36

Author(s):

Axel Stachon ◽

Elmar Segbers ◽

Tim Holland-Letz ◽

Reiner Kempf ◽

Steffen Hering ◽

...

Keyword(s):

Cohort Study ◽

Intensive Care ◽

Red Blood Cells ◽

Prospective Cohort Study ◽

Mortality Risk ◽

Blood Cells ◽

Prospective Cohort ◽

Intensive Care Patients ◽

Nucleated Red Blood Cells ◽

Medical Intensive Care

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Leucocytosis following Transfusion with Leucodepleted Red Cells to Non-Bleeding Critically Ill Patients

Journal of the Intensive Care Society ◽

10.1177/175114371301400104 ◽

2013 ◽

Vol 14 (1) ◽

pp. 11-14

Author(s):

Ezzeldin Saleh ◽

Timothy S Walsh

Keyword(s):

Intensive Care ◽

Confidence Interval ◽

Red Blood Cells ◽

Blood Cells ◽

Leucocyte Count ◽

Clinical Importance ◽

Red Cells ◽

Intensive Care Patients ◽

Routinely Collected Data ◽

And Storage

Previous studies have shown that transfusion of non-leucodepleted red blood cells can cause leucocytosis in recipients. A small study suggested that pre-storage leucodepletion removed this phenomenon, but has not been further substantiated. We explored whether recipient leucocytosis occurs when leucodepleted red blood cells were transfused to non-bleeding intensive care patients. We used routinely collected data for 95 transfusions in 54 patients. Overall, no leucocytosis was found on the first routine blood sample following transfusion (mean change 0.6 × 109/L; 95% confidence interval - 0.2 to 1.3; p=0.145). However, for the 32 transfusions in patients with normal pre-transfusion leucocyte count there was a clinically small but statistically significant leucocytosis following transfusion, unlikely to have occurred by chance (mean change 1.5 × 109/L; 0.5 to 2.5; p=0.005). No significant change was observed in patients with pre-transfusion leucocytosis. We found no relation between leucocytosis and storage age of red cells. Our data suggest that transfusions with leucodepleted red cells can increase leucocyte counts in recipients. The mechanism of this effect and its clinical importance are uncertain.

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