The Skeptics Guide to Emergency Medicine
SGEM#468: Wide Open Monocytes – Using MDW to Diagnose Sepsis
Feb 22, 2025
Dr. Aaron Skolnick, an Assistant Professor at Mayo Clinic specializing in emergency medicine, dives into the complexities of diagnosing sepsis. He discusses the promising potential of Monocyte Distribution Width (MDW) as a rapid biomarker for early detection. Skolnick highlights the challenges of identifying sepsis due to its nonspecific symptoms and critiques existing diagnostic methodologies. The conversation also covers the biases in observational studies versus randomized control trials, and evaluates the clinical implications of MDW in emergency settings.
22:14
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Quick takeaways
- Monocyte distribution width (MDW) shows promise as a diagnostic tool for sepsis but requires careful clinical interpretation due to variability in accuracy.
- While MDW's diagnostic accuracy is notable, it should complement existing criteria rather than replace established diagnostic workflows in sepsis assessment.
Deep dives
Importance of Early Sepsis Diagnosis
Rapid and accurate diagnosis of sepsis is essential, as early intervention can significantly lower patient mortality rates. However, diagnosing sepsis is often challenging due to its nonspecific symptoms, making timely recognition critical for patient outcomes. Traditional biomarkers such as procalcitonin and lactate have limitations, prompting the exploration of newer markers. One such promising marker is monocyte distribution width (MDW), which indicates variability in monocyte size and can be rapidly assessed as part of an automated complete blood count.
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