Publication:

A study on the predictive value of red blood cell distribution width as a biomarker of outcome in paediatric critical illness

Background One of the pediatric population’s interest group is critically sick children requiring medical aid services, since these children are at an extreme risk of death. Red cell distribution width (RDW) measures the variability in red corpuscle size and is calculated as proportional variation in mean corpuscular cell volume (MCV), with a traditional vary of 11.5-14.5%. The ensuing acute rise in RDW could thus say the degree of the underlying inflammatory state and supply helpful prognostic data regarding intensity of resource utilization and risk of mortality. The aim and objectives were to determine the association between RDW and mortality in critically ill children admitted to PICU.

Methods A cross sectional observational study was conducted among 103 children in the age group of 2 months to 18 years admitted to PICU at SMIMER Hospital.

Results In this study, mean age of survivors was 16.8 years. Among survivors group, in 35 (42.1%) cases there was respiratory system involvement followed by CNS involvement in 19 (22.8%) cases while in non-survivors group only in 7 (35%) cases respiratory system was involved, in 2(10%) cases CNS involved. In RDW quartile range of 16.1-19.0, 46 cases had survived and 11 deaths were noted and significant difference was found between RDW quartiles and odd’s ratio of survivor and non-survivor group.

Conclusions Raised RDW levels have been seen strongly associated with mortality and poor clinical parameters, including use of vasoactive-ionotropic drugs, oxygen as well as mechanical ventilator support. Hence, RDW can be used as a biomarker in prediction of risk mortality in PICU.