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CC BY-NC-ND 4.0 · J Lab Physicians 2019; 11(01): 029-033
DOI: 10.4103/JLP.JLP_102_18
Original Article

Volume, conductivity, and scatter parameters of leukocytes as early markers of sepsis and treatment response

Parul Arora
Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
,
Praveen Kumar Gupta
Department of Laboratory Medicine, Primus Super Speciality Hospital, New Delhi, India
,
Raghavendra Lingaiah
Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
,
Asok Kumar Mukhopadhyay
Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
› Author Affiliations Financial support and sponsorship: Nil
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Abstract

INTRODUCTION: Morphologic changes in the size and granularity of leukocytes seen in sepsis could be measured using the volume, conductivity, and scatter (VCS parameters) from the automated hematology analyzers. The objective of this study is to find the clinical usefulness of VCS parameters as possible indicators of sepsis and to determine the effect of treatment on these parameters.

METHODS: This observational study was conducted in a tertiary level hospital in India. Hemogram and VCS parameters obtained from LH 750 (Beckman coulter, Fullerton, CA) from 134 proven blood culture-positive cases of sepsis were reviewed on the day of culture positivity (day 0), day 3, and day 7 were analyzed and compared with those of samples from otherwise healthy 100 participants. Statistical analysis of data was done, and cutoff value was established using receiver-operator characteristic curve.

RESULTS: Out of 134 culture-positive cases, 55.2% (n = 74) Gram-negative and 44.8% (n = 60) Gram-positive bacteria were isolated. The mean neutrophil volume (MNV) and mean monocyte volume (MMV) were higher in the sepsis group compared to that of the control group (165.43 ± 18.21 vs. 140.59 ± 7.6, P = 0.001 for MNV and 179.8 ± 14.16 vs. 164.54 ± 9.6, P = 0.001 for MMV). A significant decrease in MNV and MMV was observed with the initiation of the treatment. Significant changes in scatter and conductivity parameters were also noticed. A cutoff value of 150.2 for MNV gave a sensitivity and specificity of 79.1% and 95%, respectively, with an area under the curve (AUC) of 92.3%. With a cutoff of 168.3, MMV had a sensitivity of 80.6% and specificity of 77.5%, AUC of 83%.

CONCLUSION: VCS parameters such as MNV and MMV can be easily obtained by an automated hematology analyzer and could be used for early detection and therapeutic response in sepsis.

Key words

Automated analyzer - monocyte - neutrophil - sepsis - volume - conductivity - scatter parameters


Publication History

Received: 28 July 2018

Accepted: 26 November 2018

Article published online:
06 April 2020

© 2019.

Thieme Medical and Scientific Publishers Private Ltd.
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