PubMed · 13838063
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G R THOMPSON. 1960. Westergren versus Wintrobe.. https://pubmed.ncbi.nlm.nih.gov/13838063/
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A 51-year-old white woman with extreme fatigue, fever episodes, weight loss, leucocytosis and increased erythrocyte sedimentation rate showed diffuse high uptake of 18F-fluorodeoxyglucose in the entire aortic wall, which is characteristic of giant cell large-vessel arteritis, such as Takayasu disease.
OBJECTIVES: Our objective was to explore inflammation, measured as erythrocyte sedimentation rate (ESR), as a predictor for the development of heart failure (HF). BACKGROUND: In recent years, evidence of the importance of inflammation in the pathophysiology of HF has emerged, and various inflammatory markers have been found to predict future HF. Erythrocyte sedimentation rate is an inexpensive and easily accessible marker of systemic inflammation, but to this date it is unknown whether ESR predicts subsequent HF. METHODS: In a community-based prospective study of 2,314 middle-aged men free from HF, myocardial infarction, and valvular disease at baseline, ESR was analyzed in multivariable models together with established risk factors for HF (hypertension, diabetes, electrocardiographic left ventricular hypertrophy, smoking, obesity, and serum cholesterol) and hematocrit. RESULTS: A total of 282 men developed HF during a median follow-up time of 30 years. In Cox proportional hazards analyses, ESR was an independent predictor of HF (hazard ratio 1.46 for highest quartile vs. the lowest, 95% confidence interval 1.04 to 2.06). This observation remained significant when also adjusting for interim myocardial infarction during follow-up. CONCLUSIONS: Erythrocyte sedimentation rate was a significant predictor of HF, independent of established risk factors for HF, and interim myocardial infarction after three decades of follow-up in a population-based sample of middle-aged men. Our findings indicate that inflammation occurs early in the process leading to HF and that ESR could be used to evaluate this process.
STUDY OBJECTIVE: To determine if intravenous hydroxyethylstarch (HES) affects the accuracy of hemoglobin (Hb) measurements, as artificial colloids are known to increase red blood cell sedimentation rates. DESIGN: Prospective, randomized study. SETTING: Tertiary-care academic medical institution. PATIENTS AND INTERVENTIONS: We randomized 40 surgical American Society of Anesthesiologists (ASA) physical status I and II patients undergoing preoperative autologous blood donation before elective orthopedic surgery. Patients were randomized to receive volume replacement with 500 mL of 6% HES 200,000/0.5 or 500 mL of electrolyte solution. Measurements of Hb concentration and leukocyte count were performed using an analyzer with a suction needle sampling from the bottom of the test tube. Measurements were performed after mixing and repeated after a 10-minute period of upright positioning of the tube (at rest). MAIN RESULTS: In the study group that received HES, Hb levels were increased above baseline after resting (mean increase to 151% of baseline values, P < .01), whereas the leukocyte count was decreased (mean decrease to 39% of baseline values, P < .01). No difference between baseline and resting measurements were observed in patients who received intravenous crystalloids. In addition, we repeatedly measured the Hb concentration in an unstirred tube with and without the addition of HES. In blood samples containing HES, the Hb concentration was increased above baseline after 2.5 minutes of resting, compared with 30 minutes without HES addition (P < .05). CONCLUSIONS: Mixing of test tube contents before sampling is critical for accurate measurement of the Hb concentration in the blood of patients who received intravenous HES.