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Related Concept Videos

Volume of Distribution01:20

Volume of Distribution

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The apparent volume of distribution (Vd) is a crucial pharmacokinetic parameter representing the hypothetical body fluid volume into which a drug disperses. It is calculated based on the total amount of drug in the body (estimated from the administered dose and bioavailability) divided by the plasma drug concentration. The total amount of drug in the body does not directly refer to the dose given but is derived by accounting for absorption, distribution, metabolism, and excretion processes.
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Magnetic Levitation Coupled with Portable Imaging and Analysis for Disease Diagnostics
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Red cell distribution width as predictor for mortality in critically ill patients.

I A Meynaar1, A H M Knook, S Coolen

  • 1Intensive Care Unit, Reinier de Graaf Hospital, Delft, the Netherlands.

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|November 13, 2013
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Summary

Red cell distribution width (RDW) is an independent predictor of mortality in critically ill patients. This finding suggests RDW may offer valuable prognostic information beyond inflammation markers.

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Area of Science:

  • Critical Care Medicine
  • Hematology
  • Clinical Pathology

Background:

  • Red cell distribution width (RDW) is a measure of the variation in red blood cell size.
  • Its role as a risk factor for mortality in critically ill patients requires further elucidation.
  • The relationship between RDW and inflammation as a potential mediator of outcome is unclear.

Purpose of the Study:

  • To determine if RDW is a significant risk factor for hospital mortality in critically ill patients.
  • To investigate whether RDW indicates inflammation or acts as an independent risk factor.
  • To explore the prognostic value of RDW in intensive care unit (ICU) admissions.

Main Methods:

  • Retrospective analysis of 2915 critically ill patients admitted to a mixed ICU.
  • RDW, C-reactive protein, and leucocyte count were measured.
  • Logistic regression and ROC curve analyses were employed to assess mortality risk and predictive accuracy.

Main Results:

  • Higher RDW values were associated with increased hospital mortality in univariate analysis.
  • RDW remained an independent predictor of mortality in multivariate analysis, even after adjusting for APACHE II score and other clinical factors (OR 1.04, 95% CI 1.02-1.06).
  • RDW showed no correlation with C-reactive protein or leucocyte count, suggesting its effect is not mediated by inflammation.

Conclusions:

  • RDW on ICU admission is an independent predictor of mortality in critically ill patients.
  • The association between RDW and mortality is not explained by inflammatory markers.
  • Further research is needed to uncover the mechanisms underlying the prognostic significance of RDW.