July 29, 2020

Is There a Key to Sepsis? Unlocking the CBC

Conversation with Industry: Beckman Coulter

This content is written by the company and does not represent the opinions of ACEP.

Case Study: Role of MDW Biomarker in the ED


Join Dr. Nima Sarani from Kansas University Medical Center as he discusses the latest evidence and practical utility of the FDA-cleared Monocyte Distribution Width (MDW) hematological biomarker as an aid in identifying the risk of severe infection and sepsis in adult patients in the emergency department.

What is Monocyte Distribution Width (MDW)?

Monocyte Distribution Width (MDW) is a severity index marker that measures increased morphological variability of monocytes in response to bacteria, viral or fungal infections. MDW assists in clinical patient assessment: higher MDW values equate to higher relative risk of severe infection in adult patients.

  • MDW, exclusive to Beckman Coulter hematology analyzers, is the only FDA-cleared hematological biomarker that helps to identify severity of infection and risk of sepsis in adult patients in the emergency department.
  • MDW helps reduce diagnostic uncertainty, aiding clinicians in escalation or de-escalation care in patients with suspected infectious etiology.
  • MDW is available early in patient assessment as a part of a CBC with Differential test, no impact to workflow.

Clinical Evidence

  • MDW has been studied for the past decade with more than 16 peer-review publications and over 21,000+ patients1-11, confirming the robustness and reproducibility of MDW performance in different patient populations.
  • The clinical utility of MDW is supported by numerous peer reviewed published studies in medical journals including Chest, Critical Care Medicine and Journal of Intensive Care.

FDA-Cleared Indications for Use

MDW is intended for use with adult patients presenting to the emergency department for whom a white blood cell differential test has been ordered. MDW is measured from a (K2EDTA) whole-blood venous sample within 2 hours of collection. MDW results greater than 20.0, together with other laboratory findings and clinical information, aid in identifying patients with sepsis or at increased risk of developing sepsis within the first 12 hours of hospital admission.

Clinical Evidence References

  1. Malinovska et al., Monocyte distribution width as part of a broad pragmatic sepsis screen in the emergency department. JACEP Open. 2022; 3:e12679. Learn More
  2. E. Piva et al., Monocyte Distribution Width (MDW) Parameter as a Sepsis Indicator in Intensive Care Units, Clin Chem Lab Med 2021. Learn More
  3. P. Hausfater et al., Monocyte Distribution Width (MDW) Performance as an Early Sepsis Indicator in the Emergency Department: Comparison with CRP and Procalcitonin in a Multicenter International European Prospective Study, Crit Care 2021; 25, 227. Learn More
  4. A. Woo et al., Monocyte Distribution Width Compared with C-Reactive Protein and Procalcitonin for Early Sepsis Detection in the Emergency Department, PLoS ONE 2021; 16(4): e0250101. Learn More
  5. H. Lin et al., Clinical Impact of Monocyte Distribution Width and Neutrophil-to-Lymphocyte Ratio for Distinguishing COVID-19 and Influenza from Other Upper Respiratory Tract Infections: A Pilot Study, PLoS ONE 2020; 15(11): e0241262. Learn More
  6. L. Agnello et al., Monocyte Distribution Width (MDW) as a Screening Tool for Sepsis in the Emergency Department, Clin Chem Lab Med 2020; 58(11):1951-1957. Learn More
  7. G. Riva et al., Monocyte Distribution Width (MDW) as Novel Inflammatory Marker with Prognostic Significance in COVID‑19 Patients, Scientific Report 2021; 11:12716. Learn More
  8. A. Marcos-Morales et al., Elevated Monocyte Distribution Width in Trauma: An Early Cellular Biomarker of Organ Dysfunction, Injury 2021; S0020-1383(21):00933-00935. Learn More
  9. E. Crouser et al., Monocyte Distribution Width: A Novel Indicator of Sepsis-2 and Sepsis-3 in High-Risk Emergency Department Patients, Critical Care Med 2019; 47:1018-1025. Learn More
  10. E. Crouser et al., Improved Early Detection of Sepsis in the ED with a Novel Monocyte Distribution Width Biomarker, CHEST 2017; 152(3):518-526. Learn More
  11. A. Ognibene et al., Elevated Monocyte Distribution Width in COVID-19 Patients: The Contribution of the Novel Sepsis Indicator, Clinica Chimica Acta 2020; 509: 22-24. Learn More

Disclaimer: This study is presented for educational purposes only and is not intended to promote any Beckman Coulter product or service. University of Kansas Medical Center names, data and images are used with permission. 

Company Summary

Beckman Coulter is committed to advancing healthcare for every person by applying the power of science, technology and the passion and creativity of our teams to enhance the diagnostic laboratory’s role in improving healthcare outcomes. Our diagnostic systems are used in complex biomedical testing and are found in hospitals, reference laboratories and physician office settings around the globe. Beckman Coulter offers a unique combination of people, processes and solutions designed to elevate the performance of clinical laboratories and healthcare networks. We do this by accelerating care with a menu that matters, bringing the benefit of automation to all, delivering greater insights through clinical informatics and unlocking hidden value through performance partnership.

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