الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. If not recognized early and managed promptly, it can lead to septic shock, multiple organ failure and death. Any type of infectious pathogen can potentially cause sepsis. Antimicrobial resistance is a major factor determining clinical unresponsiveness to treatment and rapid evolution to sepsis and septic shock. Sepsis patients with resistant pathogens have been found to have a higher risk of hospital mortality.
Anyone affected by an infection can progress to sepsis conditions but some vulnerable populations such as elderly people, pregnant women, neonates, hospitalized patients, and people with HIV/AIDS, liver cirrhosis, cancer, kidney disease, autoimmune diseases and no spleen, are at higher risk.
Sepsis is a medical emergency. However, because of the characteristics of sepsis as a disease condition with multiple causative organisms and its evolving nature over time, people with sepsis can present various signs and symptoms at different times. Warning signs and symptoms include fever or low temperature and shivering, altered mental status, difficulty breathing/rapid breathing, increased heart rate, weak pulse/low blood pressure, low urine output, cyanotic or mottled skin, cold extremities, and extreme body pain or discomfort. Suspecting sepsis is a first major step towards early recognition and diagnosis.
Procalcitonin (PCT) is a peptide precursor of the hormone calcitonin found in very low (<0.05ng/ml) or even undetectable concentrations in healthy individuals. In situations of infection, however, different body tissues (kidney, adipose tissue, lung and liver) secrete PCT into the bloodstream—concentrations of over 0.5ng/ml being regarded as pathological.
Different studies have found PCT to behave as a diagnostic marker of bacterial infection that is more reliable than other markers commonly used in clinical practice PCT also has prognostic value—its levels being related to the severity and mortality of infection.
The red cell distribution width (RDW) is a numerical measure of RBC variability and heterogeneity. RDW values are used to analyze the type of anaemia.2 Recent studies have reported that Red Cell Distribution Width is associated with prognosis in critically ill patients, sepsis in elderly, and organophosphorous compound poisoning.
The aim of the study was evaluation the red cell distribution width as a prognostic marker of sepsis and as a predictor of mortality compared with procalcitonin.
This observational study carried in Ain shams university hospitals and misr university for science and technology teaching hospital on 45 patients of both sexes who had sepsis, severe sepsis, and septic shock; all of them received the same treatment as recommended by the surviving sepsis campaign(SCC).
The patients in the study were those who were admitted to the units of the intensive care and who fulfilled the diagnostic criteria for severe sepsis or septic shock on arrival to ICU according to the SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference.
Venous blood samples were obtained on admission, day 5, and day 10 to determine red blood cell distribution width (RDW), and procalcitonin levels on admission, day 5, and day 10; the Sequential Organ Failure Assessment (SOFA) score was also measured on days 1, 5, and 10. The APACHE II score was measured only on admission. Patients were managed according to the surviving sepsis campaign guidelines.
This study revealed that the red cell distribuation width (RDW) was a significant prognostic marker of sepsis and a significant predictor of mortality compared with procalcitonin.