Challenging the Interpretation of White Blood Cell Counts in Patients with Sepsis Following Packed Cell Transfusion

Moti Klein; Lior Hassan; Rivka Katz; Ran Abuhasira; Matthew Boyko; Ohad Gabay; Dmitry Frank; Yair Binyamin; Victor Novack; Amit Frenkel

doi:10.3390/jcm12123912

Challenging the Interpretation of White Blood Cell Counts in Patients with Sepsis Following Packed Cell Transfusion

J Clin Med. 2023 Jun 8;12(12):3912. doi: 10.3390/jcm12123912.

Authors

Moti Klein^{1

2}, Lior Hassan^{2

3}, Rivka Katz², Ran Abuhasira³, Matthew Boyko⁴, Ohad Gabay¹, Dmitry Frank⁴, Yair Binyamin⁴, Victor Novack^{3

5}, Amit Frenkel¹

Affiliations

¹ General Intensive Care Unit, Soroka University Medical Center, and The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 7747629, Israel.
² The Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 7747629, Israel.
³ Clinical Research Center, Soroka University Medical Center, and The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 7747629, Israel.
⁴ Department of Anesthesiology, Soroka University Medical Center, The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 7747629, Israel.
⁵ Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA.

Abstract

Critically ill patients with sepsis often require packed cell transfusions (PCT). However, PCT may affect white blood cell (WBC) counts. We conducted a population-based retrospective cohort study to trace changes in WBC count following PCT in critically ill patients with sepsis. We included 962 patients who received one unit of PCT while hospitalized in a general intensive care unit, and 994 matched patients who did not receive PCT. We calculated the mean values of WBC count for the 24 h before and 24 h after PCT. Multivariable analyses using a mixed linear regression model were performed. The mean WBC count decreased in both groups, but more in the non-PCT group (from 13.9 × 10⁹/L to 12.2 × 10⁹/L versus 13.9 × 10⁹/L to 12.8 × 10⁹/L). A linear regression model showed a mean decrease of 0.45 × 10⁹/L in WBC count over the 24 h following the start of PCT. Every 1.0 × 10⁹/L increase in the WBC count prior to PCT administration showed a corresponding decrease of 0.19 × 10⁹/L in the final WBC count. In conclusion, among critically ill patients with sepsis, PCT causes only mild and clinically non-prominent changes in WBC count.

Keywords: infection; intensive care unit; leukocytosis; sepsis; white blood cells count.

Grants and funding

This research received no external funding.