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Red blood cell deformability in diabetic patients suffering from severe sepsis

Abstract number: P1066

Gogos C.A., Moutzouri T., Dimitropoulou D., Bassaris H., Athanassiou G.

Objectives: Diabetes mellitus and sepsis are accompanied by haemorheological abnormalities, which cause a secondary hyperviscosity syndrome involved in the pathogenesis of microvascular complications. The diabetic patients are more vulnerable to infections and sepsis is a major cause of morbidity and mortality in diabetes. The aim of the present study was to investigate the impairment of RBC deformability on a series of patients with sepsis, diabetes mellitus and diabetic patients suffering from severe sepsis.

Methods: Forty patients with severe sepsis, no history of diabetes mellitus and normal baseline glucose values, 12 patients suffering from diabetes and no infection and 24 diabetic patients with severe sepsis were enrolled in the study. All septic patients were admitted in the Department of Medicine of Patras University Medical School during a period of 6 months, while diabetic non-septic patients were enrolled from the outpatient clinics of the Endocrinology Unit. RBC deformability was measured using a filtration method based on the initial flow rate conditions of blood samples suspension by using a Nuclepore membrane based Haemorheometer. Values are expressed as the Index of Rigidity (IR)and high IR values indicate low RBC deformability

Results: We observed no differences in severity, organ dysfunction and final outcome between diabetic and non-diabetic septic patients. Mean SAPS II score was 23.5% vs 26.8% in non-diabetic and diabetic septic patients accordingly. The mortality in the group of non-diabetic septic patients was 22.5% and in the group of septic diabetics 34.3%, while septic shock occurred in 15.0% and 20.8% accordingly. Patients with sepsis and patients with diabetes mellitus had significantly (p < 0.01)higher IR than healthy controls (13.9±2.86 and 12.26±2.28 vs 8.46±1.21, accordingly. Most significantly, diabetes mellitus and severe sepsis had an additive effect on RBC deformability, as IR in those patients was significantly higher than patients with diabetes and sepsis alone (17.72±6.31).

Conclusion: It seems that both diabetes mellitus and severe sepsis compromise the RBC deformability and increase the RBC rigidity index. Interestingly, when they co-exist, they seem to have additive effects. This supports the hypothesis that the presence of diabetes mellitus further affects the already compromised deformability of the red blood cells and this may contribute to the microcirculatory functional impairments in septic diabetic patients.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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