What does nrbc stand for

The mortality of patients who were NRBC-positive on the day of relocation from the intensive care unit to a peripheral ward was This was significantly higher than the mortality of patients who were NRBC-negative on the relocation day 8. On average, NRBCs were detected for the first time 14 days median, 3 days before death. The routine analysis of NRBCs in blood is of high prognostic power with regard to mortality of critically ill patients. Therefore, this parameter may serve as a daily indicator of patients at high mortality risk.

Furthermore, NRBC-positive intensive care patients should not be relocated to a normal ward but should obtain ongoing intensive care treatment.

Under normal conditions, the peripheral blood of healthy adults is generally free of nucleated red blood cells NRBCs , which tend to be found in patients with severe diseases [ 1 - 5 ] who have a relatively poor prognosis [ 3 , 4 , 6 - 9 ]. In most of the earlier studies on NRBCs, the concentration was determined microscopically by a stained peripheral blood smear.

For several years, a more convenient and sensitive technique has been available in the form of mechanized blood analyzers.

Furthermore, the analysis of the cytokine profile in the blood of NRBC-positive patients without hematologic diseases suggests that NRBCs may be considered a parameter that sums hypoxic and inflammatory injuries.

This may be the reason why the appearance of NRBCs is a strong predictor of increased mortality [ 15 - 17 ]. Recently, we reported on the poor prognosis of surgical intensive care patients when NRBCs are found in the peripheral blood [ 18 ].

In that study, for the first time, a systematic day-to-day screening for NRBCs in the blood of surgical intensive care patients was performed. The area under the curve amounted to 0. On average, NRBCs were detected nine days before death. Therefore, in the present study, we set out to establish whether the daily screening for NRBCs in medical intensive care patients could serve as an early indicator of medical intensive care patients at extremely high risk.

The detection of NRBCs was associated with a greatly increased in-hospital mortality. Furthermore, the mortality was three times higher in patients who were NRBC-positive on the day of relocation from the intensive care unit to a peripheral ward compared to patients who were NRBC-negative on the relocation day.

On average, NRBCs were detected 14 days before death. These results suggest that the routine daily measurement of NRBCs could aid in a daily risk assessment of medical intensive care patients. Patients younger than 18 years and patients after surgery were excluded from this study. Blood samples were routinely drawn in the morning. Outcome was considered as in-hospital mortality. Ethical approval to conduct this study was granted by the Ethical Committee of Ruhr-University Bochum reference no.

Blood count parameters NRBCs, leukocytes, hemoglobin, and thrombocytes were measured using a Sysmex XE blood analyzer in line with the manufacturer's recommendations.

Stringent internal quality control measurements were performed, and the criteria of acceptance were fulfilled throughout. The criteria of acceptance were fulfilled throughout. Retrospective analysis of the laboratory data revealed 0.

When samples were normally distributed, the differences between the data for survivors and deceased were analyzed using the t test procedure. When samples were not normally distributed, the Mann-Whitney test was used because this test does not require a normal distribution of data. In the case of categorical data, the Fisher exact test was used. Correlations were analyzed by Pearson or non-parametric Spearman correlation. A p value of less than 0.

A receiver operating characteristic curve was obtained by plotting the true-positive proportion sensitivity against the false-negative proportion 1 — specificity. The area under the curve C-statistics was calculated by non-linear regression. The prognostic significance of NRBCs and other risk indicators was assessed using multiple logistic regression.

In this study, the logistic regression tries to estimate the relative effect that parameters have on the patients' outcome. This is facilitated by assuming a functional relationship the 'logistic model' between variables and probability of outcome. Then, for all possible settings, every variable is given a relative importance that makes the actual observed event 'most likely', taking into account the effects of all other variables.

This is called the 'maximum likelihood' estimate of the variables' influence. These coefficients provide a relative weighting for each variable.

Moreover, they can be used to derive odds ratios for the variables. If the odds ratio differs significantly from 1, a significant prognostic power that is independent of the other variables considered may be assumed. In a first step, laboratory data were analyzed with regard to mortality. If reasonable for calculation of the odds ratios, the data were categorized in up to four categories.

A backward selection multiple logistic regression analysis was performed by first including all parameters in a multivariate model and subsequently leaving out the parameters with the largest p values until no parameter with a p value greater than 0. The calculations were carried out using SAS version 8. The intention of this study was to evaluate the prognostic power of the presence of NRBCs in the blood with regard to the patients' in-hospital mortality risk.

The APACHE II severity index includes the following risk factors: body temperature, mean arterial pressure, heart rate, respiratory rate, blood oxygenation, arterial pH, sodium, potassium, creatinine, hematocrit, white blood cell count, Glasgow coma scale, age, and anamnestic data concerning severe organ insufficiency or immunocompromised states of health.

The SAPS II considers the following risk factors: age, heart rate, systolic blood pressure, body temperature, blood oxygenation, urinary output, urea, white blood cell count, potassium, sodium, bicarbonate, bilirubin, Glasgow coma scale, chronic diseases that is, malignancies and acquired immunodeficiency syndrome , and type of admission that is, medical and unscheduled surgical. We included medical intensive care patients. The mean age was Two hundred twenty-five male On average, patients were treated for 4.

Total mortality was The incidence of NRBCs in the blood was No significant difference was found between the incidences in male On the day of admission, 7. On average, NRBCs were detected for the first time on the third day of intensive care treatment 3. Intensive care days on which nucleated red blood cells were detected for the first time in the blood of medical intensive care patients. The mortality was In contrast, the mortality of NRBC-negative patients was 9.

In-hospital mortality of medical intensive care patients in relation to the concentration of nucleated red blood cells NRBCs in the blood. Numbers in parenthesis denote the ratio of deceased patients to all patients with the respective NRBC concentration. Furthermore, the mortality of patients who were NRBC-positive on the day of relocation from the intensive care unit to a peripheral ward was Overall, with regard to in-hospital mortality, NRBCs in blood showed sensitivity and specificity of The area under the curve was 0.

NRBCs were an early indicator of patients at increased mortality risk. After the first detection of NRBCs in blood and during the further course of intensive care treatment, when the NRBCs have disappeared from the circulation, the mortality again decreased.

However, patients who have died from infections or sepsis, in particular, had significantly higher NRBC concentrations than patients who have died from cerebral or pulmonary complications.

None of the other defined causes of death was associated with an NRBC concentration that was significantly higher than the others. Concentration of nucleated red blood cells NRBCs in the blood of medical intensive care patients who have died from various causes.

The average concentration is indicated by horizontal bars. The concentrations of hemoglobin, thrombocytes, and C-reactive protein as well as the alanine aminotransferase activity were not significantly correlated with the NRBC concentration. Correlation was calculated with values measured on the day of the first appearance of nucleated red blood cells in blood.

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See our Privacy Policy for more details. Optimal Result: 0 - 0. They may be seen in: severe anemia, myelofibrosis, thalassemia, miliary tuberculosis, cancers that involve the bone marrow, and in chronic low oxygen levels hypoxemia. Nucleated RBCs can be normal in infants for a short time after birth. Understand Lab Results. The primary way to decrease nucleated RBCs is to address any underlying conditions. Work with your doctor to find an accurate diagnosis and to determine the appropriate next steps to improve your health.

We recommend strongly against making significant exercise, diet, or supplement changes without consulting a physician, as unexpected interactions may arise. Avoid more intense and strenuous forms of exercise as these can damage and destroy red blood cells.

This is one of the reasons that endurance athletes often have anemia [ 13 ]. Note that the supplements above have not been approved by the FDA. The data supporting their use is still considered insufficient, so talk to your doctor about them to make the best possible decisions to support your health.

Nucleated red blood cells NRBCs are immature red blood cells produced in the bone marrow. In adults, their presence in the blood indicates a problem with bone marrow integrity or red blood cell production. Possible causes of NRBCs in the blood include anemia, low oxygen, spleen dysfunction, and bone marrow damage and disorders.

You can reduce NRBCs by addressing the underlying cause. If you have anemia, make sure to exercise regularly, eat a nutritious diet, and reduce alcohol. Joe Cohen won the genetic lottery of bad genes. As a kid, he suffered from inflammation, brain fog, fatigue, digestive problems, anxiety, depression, and other issues that were poorly understood in both conventional and alternative medicine. All of our content is written by scientists and people with a strong science background.

Nucleated red blood cells are immature red blood cells. In adults, their presence in the blood indicates a problem. Your doctor may order an NRBC test if your complete blood count test results indicate issues. To avoid mistakes, NRBC count should be confirmed manually. NRBCs can show up in the blood due to low oxygen caused by blood loss or different health conditions.

Conditions that affect the spleen can prevent the removal of NRBCs from the blood.