Erythrocyte rheology is of interest in understanding microcirculation and oxygen delivery and consumption alterations induced by sepsis and septic shock. Several mechanisms are proposed: (i) direct or indirect RBC membrane alterations, (ii) abnormal intraerythrocytic homeostasis, (iii) RBCs interaction with other cells and extracellular molecules, (iiii) increased reactive species production and altered redox homeostasis. In this review, we describe in part these mechanisms and what’s the impact of these hemorheological disturbances on the outcome and mortality rate. Also, we outline the possible therapeutic interventions and further perspectives regarding sepsis and septic shock management.
Red blood cell distribution width (RDW) is a hematological parameter usually measured with every complete blood count. Its place in daily practice is mainly in the differential diagnosis of anemia, but nowadays, researchers are focused on different approaches for the erythrocyte’s changes in function and morphology.
Sepsis and its most advanced form, septic shock, induces profound disturbances into organ system’s function and morphology. The red blood cells physiology and structure are directly and indirectly altered by these im balances produced in sepsis. RDW was studied in many diseases, like acute heart failure, acute stroke, inflammatory bowel diseases, chronic lung diseases and cancer, but also in sepsis. Its changes are seen to be mainly associated with prognosis. Higher values of RDW are correlated with mortality and severity of illnes in septic and all-cause critically ill patients. RDW was studied also as an independent variable in different predictive scores and some studies suggest it should be introduced in the scores use on a daily basis in critical care settings and emergency departments.
In this review we will focus on how RDW was associated with mortality and severity of illness in the recent literature, as an independent prognosis factor and as a component part in different predictive and severity scores.