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What Causes Elevated WBC Count With CRRT Dialysis Machine Insertion?

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Posted on Sat, 24 May 2014
Question: Intubated patient has wbc 28 ? What is the reason ? Pt is now on crrt dyalisis machine. Pt had respiratory failure in the hospital pt was intubated. All lab work is showing normal except wbc keeps increasing
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Answered by Dr. Vinay Bhardwaj (4 hours later)
Brief Answer:
Rising white count a sign of infection & stress

Detailed Answer:
Hello, Thanks for coming to HealthCareMagic

I'm sorry to hear about your patient. Int his particular case there are 2 reasons why the white count would be rising.

1) Dialysis XXXXXXX insertion and dialysis itself can induce a reactive rise in the White count. This is transient though and should come to normal

2) Infections, ICU patients tend to be very susceptible to infections (the body is already suffering from whatever got them into the ICU in the first place. The immune system is weakened)

What I would do in this case is look at the trend over a day or two and send PAN cultures (they send blood samples from different parts of the body to look for a blood borne infection, Urine culture and Tracheal aspirate cultures.

These cultures would be ready to read in a day or 2. So now in the interim period the ICU doctor has to decide whether to treat suspected infection or to wait for the results of the cultures. That depends on the condition of the patient, whether they have a fever or not and a million other tiny signs that we learn to read over the years. All in all its a gut call. The proof though is the culture.

If the doctor is suspecting a lung infection then they will get a chest x-ray. If they are suspecting a urinary tract infection then the dctor may also get a urinalysis which will come back faster but doesn't always show infections even when they are there.

So , to sum up. The high WBC count may be due to recent dialysis or (in my opinion more likely) due to an infection which then needs to be worked up as I have mentioned. The count may also be a combination of the two.

I hope this helps. ICU care is tough in family, I hope everything turns out well and God bless you.

Thanks for coming to HealthCareMagic. Feel free to follow-up

Vinay
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Vinay Bhardwaj

Neurologist, Surgical

Practicing since :2006

Answered : 544 Questions

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What Causes Elevated WBC Count With CRRT Dialysis Machine Insertion?

Brief Answer: Rising white count a sign of infection & stress Detailed Answer: Hello, Thanks for coming to HealthCareMagic I'm sorry to hear about your patient. Int his particular case there are 2 reasons why the white count would be rising. 1) Dialysis XXXXXXX insertion and dialysis itself can induce a reactive rise in the White count. This is transient though and should come to normal 2) Infections, ICU patients tend to be very susceptible to infections (the body is already suffering from whatever got them into the ICU in the first place. The immune system is weakened) What I would do in this case is look at the trend over a day or two and send PAN cultures (they send blood samples from different parts of the body to look for a blood borne infection, Urine culture and Tracheal aspirate cultures. These cultures would be ready to read in a day or 2. So now in the interim period the ICU doctor has to decide whether to treat suspected infection or to wait for the results of the cultures. That depends on the condition of the patient, whether they have a fever or not and a million other tiny signs that we learn to read over the years. All in all its a gut call. The proof though is the culture. If the doctor is suspecting a lung infection then they will get a chest x-ray. If they are suspecting a urinary tract infection then the dctor may also get a urinalysis which will come back faster but doesn't always show infections even when they are there. So , to sum up. The high WBC count may be due to recent dialysis or (in my opinion more likely) due to an infection which then needs to be worked up as I have mentioned. The count may also be a combination of the two. I hope this helps. ICU care is tough in family, I hope everything turns out well and God bless you. Thanks for coming to HealthCareMagic. Feel free to follow-up Vinay