The Role of New Morphological Parameters Provided by the BC 6800 Plus Analyzer in the Early Diagnosis of Sepsis.

BACKGROUND: Late diagnosis of sepsis is associated with adverse consequences and high mortality rate. The aim of this study was to evaluate the diagnostic value of hematologic research parameters, that reflect the cell morphology of blood cells, available on the BC 6800 plus automated analyzer (Mindray) for the early detection of sepsis. MATERIALS AND METHODS: A complete blood count (CBC) was performed by Mindray BC 6800 Plus Analyzer in 327 patients (223 with a confirmed diagnosis of sepsis following sepsis-3 criteria, 104 without sepsis), admitted at the Intensive Care Unit of the Novara's Hospital (Italy) and in 56 patients with localized infection. RESULTS: In univariate logistic regression, age, Hb, RDW, MO#, NMR, NeuX, NeuY, NeuZ, LymX, MonX, MonY, MonZ were associated with sepsis (p < 0.005). In multivariate analysis, only RDW, NeuX, NeuY, NeuZ, MonX and MonZ were found to be independent predictors of sepsis (p < 0.005). Morphological research parameters are confirmed to be predictors of sepsis even when analyzing the group with localized infection. CONCLUSIONS: In addition to already established biomarkers and basic CBC parameters, new morphological cell parameters can be a valuable aid in the early diagnosis of sepsis at no additional cost.

Preliminary evaluation of a new flow cytometry method for the routine hematology workflow.

Background In a generalist laboratory, the integration of the data obtained from hematology analyzers (HAs) with those from multiparametric flow cytometry (FMC) could increase the specificity and sensitivity of first level screening to identify the pathological samples. The aim of this study was to perform a preliminary evaluation of a new simple hybrid method (HM). The method was obtained by integration between HAs reagents into FCM, with a basic monoclonal antibodies panel for the leukocytes differential count. Methods Eighty-one peripheral blood samples, collected in K3EDTA tubes, were analyzed by XN-module, and CyFlow Space System, using both standard MoAbs and HM method analysis, and with the optical microscopy (OM). Within-run imprecision was carried out using normal samples, the carryover was evaluated, data comparison was performed with Passing-Bablok regression and Bland-Altman plots. Results The within-run imprecision of HM methods ranged between 1.4% for neutrophils (NE) and 10.1% for monocytes (MO) always equal or lower to the OM. The comparison between HM methods vs. OM shows Passing-Bablok regression slopes comprised between 0.83 for lymphocyte (LY) and 1.14 for MO, whilst the intercepts ranged between -0.18 for NE and 0.25 for LY. Bland-Altman relative bias was comprised between -12.43% for NE, and 19.77% for eosinophils. In all 11 pathological samples the agreement between the methods was 100%. Conclusions The new hybrid method generates a leukocytes differential count suitable for routine clinical use and it is also useful for identifying morphological abnormalities with a reduction in cost and improvement of screening for first level hematology workflow.

Decreased mean sphered cell volume values in top-level rugby players are related to the intravascular hemolysis induced by exercise.

Sports anemia is a common risk for athletes. Intravasclar hemolysis is the principal source of an accelerated turnover of erythrocytes in sportsmen. The hemolysis induces some biochemical and hematological modifications; in particular, high concentrations of total and indirect (unconjugated) bilirubin could be reported in professional athletes. We recruited 24 rugby players of the Italian National Team. In these athletes we measured hematological parameters, including mean sphered cell volume (MSCV) by means of Coulter LH 750 (Beckman Coulter, Brea, CA, USA), beside biochemical parameters, including bilirubin and haptoglobin. We observed differences in the athletes' indirect bilirubin between the blood drawing performed before the start of training and competitions and the one performed at the end of the competition season. The bilirubin was increased during competition season from 7% to 329% when compared with the baseline value measured before training and competitions. MSCV, in contrast, decreased from a mean of 88.4 fL to 86 fL. The MSCV decrease in association with an indirect bilirubin increase is a specific sign of erythrocyte destruction, and specific training and competitions schemes and diet or therapy modifications should be decided according to their values. The modifications of MSCV are correlated with those of haptoglobin and hemoglobin, but not with reticulocytosis.