Detect Sepsis Earlier

Diagnostic uncertainty is a major challenge for patients presenting to emergency department (ED) with low number of signs and symptoms. What if there was a way to aid emergency departments in early sepsis detection?

Hematology-based Cellular Biomarker in the Emergency Department

Monocyte Distribution Width (MDW) is a measure of increased morphological variability of monocytes in response to bacterial, viral or fungal infections. The quantitative analysis of MDW has received regulatory clearance to help emergency department physicians identify patients with severe infection leading to sepsis.

Considered with other signs and symptoms, the value of MDW helps differentiate sepsis from non-septic presentations, including non-infectious systemic inflammatory response.4 This parameter is automatically reported with the complete blood count (CBC) with differential on the DxH 900 and DxH 690T hematology analyzers*, enabling automatic reporting without added workload burden. 


Key Findings from Journal of Intensive Care Study  The performance of MDW for sepsis detection has been evaluated in the prospective observational study of 2,158 emergency department patients in three large academic centers.

Diagnostic Performance for Sepsis Detection

Considering MDW together with WBC, MDW may add to the sensitivity and specificity of sepsis detection, as part of the standard assessment protocol in the emergency department.4,5

Sensitivity and Specificity for Sepsis Detection using WBC and MDW

MDW in Patients with "Gray Zone" Symptoms

Diagnostic uncertainty is a major challenge for patients presenting to the emergency department with a low number of signs and symptoms.

Using MDW to augment clinical signs and symptoms for early sepsis detection in ED

MDW Modulates the Probability of Sepsis

When considered with the standard physiologic parameters at the time of patient presentation, abnormal values of MDW signify a 4-6x increase in probability of sepsis diagnosis. 

Abnormal MDW at presentation increases the odds of sepsis

Additional MDW Patient Case Studies

T-47 Minutes to Antibiotics Administration

MDW biomarker identified a risk of severe infection and reclassified the patient into higher acuity category in conjunction with current standard of care.

T-47 Minutes to Antibiotics Administration-450x450

Abnormal MDW 27.3 Changed Patient’s Trajectory

The inclusion of monocyte distribution width (MDW) biomarker in the clinical thought process helped physicians to uncover an underlying infection which could have otherwise been missed leading to inappropriate therapeutic interventions. We can prevent sepsis by preventing evolution of infection to sepsis.

Abnormal MDW 27.3 Changed Patient’s Trajectory-450x450

Latest Scientific Presentations

Watch ISICEM 2021 symposium recording to hear Profs. Jean-Louis Vincent, Pierre Hausfater and Fernando Arméstar Rodríguez discussion on MDW and the latest clinical evidence for its utility to detect severe infection and risk of sepsis. View on demand ›

Watch the latest ACEP20 recording where Dr. Osborn and Dr. Hausfater review the current state of clinical evidence for MDW derived from the series of multicenter studies and discuss the practical implications of these results to the U.S. and European standards of sepsis care. Watch recording ›

Watch this expert presentation recording from Sepsis Alliance Summit 2021 with Angela D. Craig, APN, M.S., CCNS from Cookeville Regional Medical Center and Dustin Pierce, RN, BSN, CPHQ from University of Kansas Hospital as they review sepsis care, introduce MDW severity index marker, review patient case studies and discuss controversies in sepsis care. Watch recording ›

Watch the ISLH 2021 on-demand workshop to hear Dr. Czader, Indiana University, and Dr. Morales, University Hospital Germans Trias i Pujol, discuss the role of monocytes and neutrophils in innate immune response to infection, monocytes morphology in clinical decision-making and present emerging evidence based on multicentric European clinical trials. Watch recording >

The value of MDW is that it provides physicians with an earlier indication of sepsis during the initial encounter, which is especially important when a patient’s symptoms are mild and alternative diagnosis are being considered.
Elliott Crouser, M.D., professor of Critical Care Medicine
Ohio State University Wexner Medical Center

Learn More About Early Sepsis Detection

View clinical studies, scientific presentations, white papers and the latest webinars that review the clinical utility of MDW.

Critical Care Medicine Sepsis Study

Peer-Reviewed Clinical Study Critical Care Medicine Study

Discover how a multicenter study validated MDW as a novel indicator for Sepsis-2 and Sepsis-3 in high-risk emergency department patients.

Read study
MDW Clinician Training Video

Video MDW Clinician Training

In this clinician training video Dr. Steve Ness will walk you through the clinical utility of MDW and explain the potential benefits of using the biomarker to aid in early sepsis detection for patients in your emergency department.

Watch video

Additional Resources

*Using Early Sepsis Indicator application on Beckman Coulter DxH 900 and DxH 690T analyzers. Activation is required.

1Rudd, et al., Lancet. 2020 Jan 18; 395 (10219): 200-211.
2Torio C, Moore B. “National Inpatient Hospital Costs: The Most Expensive Conditions by Payer.”, May 2016. Accessed 15 Jan. 2018.
3Filbin, M. R., Lynch, J., Gillingham, T. D., Thorsen, J. E., Pasakarnis, C. L., Nepal, S., et al. Presenting Symptoms Independently Predict Mortality in Septic Shock. Critical Care Medicine, 2018; 46(10), 1592-1599.
4UniCel DxH 900 Coulter Cellular Analysis System Early Sepsis Indicator (ESId) Application AddendumPN C42014AA.
5Sepsis Pivotal Repository PN C54726 Rev. AB located in CPDM.
6Crouser, E. D., Parrillo, J. E., Martin, G. S., Huang, D. T., Hausfater, P., Grigorov, I., Careaga, D., Osborn, T., Hasan, M, Tejidor, L. Monocyte Distribution Width Enhances Early Sepsis Detection in the Emergency Department Beyond SIRS and qSOFA. Journal of Intensive Care, 2020; 8(1).