red cell distribution width elevation and sepsis in pediatric critically ill patients

Background: recently, a relationship has been demonstrated between red blood cell distribution width (rdw) and mortality risk in critically ill patients although the exact mechanism of this association is still vague. however, the impact of changes in rdw on sepsis and its outcome in critically ill patients has not been widely studied. therefore, we studied the prognostic impact of changes in rdw in critically ill pediatric patients with sepsis. methods: a total of 304 patients who were admitted to pediatric intensive care unit were selected to participate in this study. the changes in rdw on the day of admission and 4 and 8 days after admission in picu were documented and their relationship with sirs positivity, sepsis, and mortality were analyzed. results: the mortality rate in our patients was 10.5%. in total, 39.8% of patients were sirs positive and 50.4% fulfilled the criteria of sepsis. the mean of rdw at the time of admission, on day 4 and on day 8 of admission was 14.8%, 16.1%, and 16.6%, respectively. at the time of admission, rdw had a significant correlation with mortality and sirs positivity, but rdw measured on days 4 and 8 of admission did not correlate with neither of them. neither of rdw0, rdw4, nor rdw8 did correlate with sepsis criteria fulfillment. ∆rdw day 4-adm > 0.2%, ∆rdw day 8-adm > 0.2%, ∆rdw day 8-day 4 > 0.2% exhibited no correlation with sirs positivity, sepsis, and mortality. conclusions: we found that an increase in rdw from baseline during the first 4 and 8 days after admission of critically ill pediatric patients did not correlate with their mortality, sirs positivity, and sepsis. however, elevated baseline rdw is a valuable prognostic marker in patients with sepsis.