The relationship between hemorheological parameters and mortality in critically ill patients with and without sepsis

Kinga Totsimon, Katalin Biro, Zsofia Eszter Szabo, K. Tóth, Peter Kenyeres, Zsolt Marton

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

PURPOSE: 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). CONCLUSION: 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.

Original languageEnglish
Pages (from-to)119-129
Number of pages11
JournalClinical Hemorheology and Microcirculation
Volume65
Issue number2
DOIs
Publication statusPublished - 2017

Fingerprint

Critical Illness
Sepsis
Erythrocytes
Cell Aggregation
Blood Viscosity
Mortality
Osmolar Concentration
Intensive Care Units
Calcium
Critical Care
Hematocrit
Survivors
Perfusion
Hemodynamics

Keywords

  • Critically ill patients
  • red blood cell aggregation
  • red blood cell deformability
  • sepsis
  • viscosity

ASJC Scopus subject areas

  • Physiology
  • Hematology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

The relationship between hemorheological parameters and mortality in critically ill patients with and without sepsis. / Totsimon, Kinga; Biro, Katalin; Szabo, Zsofia Eszter; Tóth, K.; Kenyeres, Peter; Marton, Zsolt.

In: Clinical Hemorheology and Microcirculation, Vol. 65, No. 2, 2017, p. 119-129.

Research output: Contribution to journalArticle

Totsimon, Kinga ; Biro, Katalin ; Szabo, Zsofia Eszter ; Tóth, K. ; Kenyeres, Peter ; Marton, Zsolt. / The relationship between hemorheological parameters and mortality in critically ill patients with and without sepsis. In: Clinical Hemorheology and Microcirculation. 2017 ; Vol. 65, No. 2. pp. 119-129.
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AU - Kenyeres, Peter

AU - Marton, Zsolt

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N2 - PURPOSE: 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). CONCLUSION: 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.

AB - PURPOSE: 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). CONCLUSION: 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.

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