Red cell distribution width as a biomarker for respiratory failure in pediatric ICU / Abdelmonem Abdallah Abdelsalam Aboalnour ; Supervised Nabil Abdelaziz Mohsen , John Rene Labib , Reem Jan Farid

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

The red cell distribution width (RDW) is routinely reported in automated complete blood counts. It is a widely available, inexpensive, and highly reproducible test reflecting the range of the size of the circulating red blood cells (Bessman et al., 1983). Any process that releases reticulocytes in the circulation will lead to increase in RDW (Yčas et al., 2015). More and more reports highlight that RDW may be indicative of a person{u2019}s underlying general health status, and more specifically reflects a certain degree of inflammation. A correlation between RDW and Creactive protein (CRP) values has been shown, and a higher RDW can be linked to increases in erythrocyte sedimentation rate and interleukin-6 levels as well (Lee and Kim, 2010).In the critical care unit, RDW is associated with higher mortality in adult patients with single organ failure i.e. acute kidney injury necessitating continuous renal replacement therapy (Oh et al., 2011). RDW is linked in the general population with pulmonary dysfunction too (Grant et al., 2003). Searching for prognostic factors for organ dysfunction in the PICU is however essential, as single and multiple organ dysfunction is the prime cause of death in the PICU population (Proulx et al., 2009).The value of RDW remains largely unexplored in the pediatric critical care population (pediatric critical care unit; PICU). In critical illness, the acute systemic inflammatory response resulting from a multitude of underlying etiologies can alter both erythropoiesis and erythrocyte maturation. The resulting acute rise in RDW may therefore reflect the degreeof the underlying inflammatory state and provide useful prognostic information about intensity of resource utilization and risk of mortality (Förhécz et al., 2009)

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