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Hematocrit 24: Hematocrit and Hemoglobin

Importance of Red Blood Cells

What Are Red Blood Cells?

Red blood cells, or erythrocytes, are one of the components of blood. (The others are plasma, platelets and white blood cells.) They are continuously produced in our bone marrow. Just two or three drops of blood can contain about one billion red blood cells – in fact, that’s what gives our blood that distinctive red color.

What Is the Function of Red Blood Cells?

Red blood cells carry oxygen from our lungs to the rest of our bodies. Then they make the return trip, taking carbon dioxide back to our lungs to be exhaled.

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What Does a Low Red Blood Cell Count Mean?

A low red blood cell count, known as anemia, can cause fatigue, shortness of breath, dizziness and other symptoms. If untreated, anemia can lead to serious complications. In many cases, anemia occurs when we don’t eat a nutrient rich diet; choosing foods that are rich in iron and other vitamins and minerals can help raise the red blood cell count. Learn about heme iron and which foods are considered rich in iron. 

Anemia can also be caused by pregnancy and certain medical conditions such as bleeding disorders and kidney disease. Talk to your doctor to determine the best course of treatment.

How Are Red Blood Cells Used in Medicine?

Red blood cells are the most commonly transfused blood component. Patients who benefit most from receiving red blood cells include those with chronic anemia resulting from kidney failure or gastrointestinal bleeding, and those with acute blood loss resulting from trauma. They can also be used to treat blood disorders such as sickle cell disease.

How Are Red Blood Cells Collected?

Red blood cells are prepared from whole blood by removing the plasma (the liquid portion of the blood). Sometimes this is done after a person donates a pint of whole blood, resulting in multiple components (red cells, plasma and platelets) that can be given to different patients. Learn more about the different components that can be obtained from a whole blood donation.  

Other times, it is done during the donation itself, using a process called apheresis. In this case, only the red cells are retained and the patient’s plasma and platelets are returned to them. Some donors say that this leaves them feeling more hydrated than giving a whole blood donation.

Red cells have a shelf life of up to 42 days, depending on the type of anticoagulant used when they are stored. They can also be treated and frozen for 10 years or more.

Why Donations Are So Important

Recent studies show that there is a need for blood transfusions every 2 seconds, all of which must be collected from volunteer donors. One powerful way to help is to donate what the Red Cross calls “Power Red.” By donating Power Red, you double your impact by contributing two units of red blood cells in just one donation.

Learn More About Blood Components

Platelets
Plasma
Red Blood Cells
Cryoprecipitate
Whole Blood
Hematocrit
White Blood Cells

Donate Power Red and help trauma patients, surgery patients, people with sickle cell anemia, and others.  

Lab Test: Hematocrit Level














Lab Test: Hematocrit Level

    Lab Test

    • Hematocrit

    Description

    • Ratio of the volume of red blood cells to volume of whole
      blood expressed as a percentage or as a decimal fraction (SI
      units). 
    • The
      Hct is a measure of the percentage of the total blood volume that is made up by
      the RBCsThe height of the RBC column is measured
      after centrifugation and is compared to the height of the column
      of the total whole blood.  The ratio of the height of the RBC column
      compared with the original total blood column is multiplied by 100% and
      this is
      the Hct value.  The Hct in
      percentage points usually is approximately three times the Hgb
      concentration in g/dL when RBCs are of normal size and contain normal
      amounts of
      Hgb.

    Reference Range

    • Adult females, whole blood:  36%-46% (0.36-0.46)
    • Adult males, whole blood: 
      41%-53% (0.41-0.53)
    • Fetal and cord blood:
      • 18 to 20 weeks’ gestation: 
        35.86% +/-3.29 (0.36+/0.03)
      • 21 to 22 weeks’ gestation: 
        38.53% +/-3.21 (0.39+/0.03)
      • 23 to 25 weeks’ gestation: 
        38.59% +/-2.41 (0.39+/0.02)
      • 26 to 30 weeks’ gestation: 
        41.54%+/-3/31 (0.42+/0.03)
    • Pregnant female: 
      >33%
    • Child/adolescent:
      • Newborn:  44%-64%
      • 2-8 weeks:  39%-59%
      • 2-6 months:  35%-50%
      • 6 months-1 year: 
        29%-43%
      • 1-6 years:  30%-40%
      • 6-18 years:  32%-44%
    • Critical Values:
      • <21% or >65%

    Clinical Application

    • Decisions
      concerning the need for blood transfusion are usually based on the Hgb or the
      Hct.  In an otherwise healthy person,
      transfusion is not usually considered as long as the Hgb is above 8 g/dL or the Hct is
      above 24%.   In younger people who can
      safely and significantly increase their cardiac output, a Hct of 18% may be
      acceptable.  In an older individual with
      an already compromised oxygen-carrying capacity (caused by cardiopulmonary
      diseases), transfusion may be recommended when the Hct level is below 30%. 
    • Increased
      levels may indicate:
      • Erythrocytosis,
        congenital heart disease, polycythemia vera, severe dehydration (e.g., severe
        diarrhea, burns), or severe chronic obstructive pulmonary disease (COPD). 
    • Decreased
      levels may indicate:
      • Anemia, hemoglobinopathy, cirrhosis, hemolytic
        anemia (e.g., erythroblastosis fetalis, hemoglobinopathies, drug-induced
        hemolytic anemias, paroxysmal nocturnal hemoglobinuria), hemorrhage, dietary
        deficiency, bone marrow failure, prosthetic vales, renal disease, normal
        pregnancy, rheumatoid/collagen-vascular disease (e.g., rheumatoid arthritis,
        lupus), lymphoma, multiple myeloma, leukemia, or Hodgkin disease.

    Related Tests

    • Hemoglobin – this is a measurement of the concentration of
      Hgb in the blood and is closely associated with the RBC count and Hct value.
    • Red blood cell count – this is a measurement of the number
      of RBCs per cubic millimeter of blood.
    • Red blood cell indices – these provide data
      about the size and Hbg content of the RBC.

    Drug-Lab Interactions

    • Drugs that may cause decreased levels include
      chloramphenicol and penicillin.

    Test Tube Needed

    • Whole blood – EDTA (lavender top) tube
    • Capillary – heparin (green top) tube

    Procedure

    • Collect whole blood sample or capillary blood sample (only
      0.5 mL is required with capillary samples).
    • Avoid hemolysis. 
    • Obtain fetal blood by percutaneous umbilical blood
      sampling
    • Apply pressure or a pressure dressing to the
      venipuncture site and assess the site for bleeding.

    Storage and Handling

    • Sample
      stable for 48 hours at 4°C or 6 hours at 23°C.

    What To Tell Patient Before & After

    • Explain the procedure to the patient.
    • Tell the patient that no fasting is required.

    References

    • LaGow B et al., eds. PDR Lab Advisor. A Comprehensive
      Point-of-Care Guide for Over 600 Lab Tests. 
      First ed. Montvale, NJ: Thomson PDR; 2007.
    • Pagana K, Pagana TJ eds. Mosby’s Manual of
      Diagnostic and Laboratory Tests. 5th Ed.  St. Louis, Missouri. 2014.

MESH Terms & Keywords

  • Hematocrit

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GDH blood glucose meter – eBsensor – Visgeneer – eBmonitor

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Features 90 012

Technology
GDH
Other measured parameters
hematocrit
Other specifications
USB
Display time

5 s, 10 s

Memory capacity

180 unit

Weight

75 g, 80 g (2. 6 oz)

Description

Stylish and compact design without compromising performance and accuracy.
Blood sample type – capillary and venous whole blood
Blood volume – 0.5 ml
Acceptable hematocrit range – 20% ~ 60%
Measuring range – 20 ~ 600 mg / dl (1.1 ~ 33.3 mmol / l)
Units – mg/dl and mmol/l (interchangeable)
Time display – 24H
Operating temperature range – 10 ~ 40℃
Relative humidity operating range – below 85%
Meter storage conditions – 0 ~ 50℃
Meter storage humidity range – below 95
Dimensions LxWxH (mm) – 87 x 60 x 21 mm
Power supply – two 1.5 volt AAA batteries
Data output – RS232/USB interface PC
Blood sample type – capillary whole blood
Blood volume – 0.5 ml
Acceptable hematocrit range – 20% ~ 60%
Measuring range – 20 ~ 600 mg / dl (1.1 ~ 33.3 mmol / l)
Units – mg/dl and mmol/l (interchangeable)
Time display – 24H
Operating temperature range – 10 ~ 40℃
Relative humidity operating range – below 85%
Meter storage conditions – 0 ~ 50℃
Meter storage humidity range – below 95
Dimensions LxWxH (mm) – 87 x 60 x 21 mm
Power supply – two 1. 5 volt AAA batteries
Data output – RS232/USB interface PC
Blood sample type – capillary whole blood
Blood volume – 2.5 ml
Acceptable hematocrit range – 20% ~ 60%
Measuring range – 20 ~ 600 mg / dl (1.1 ~ 33.3 mmol / l)
Units – mg/dl and mmol/l (interchangeable)
Time display – 24H
Operating temperature range – 10 ~ 40℃
Relative humidity operating range – below 85%
Meter storage conditions – 0 ~ 50℃
Meter storage humidity range – below 95
Dimensions LxWxH (mm) – 87 x 60 x 21 mm
Power supply – two 1.5 V AAA batteries
Data output – RS232/USB interface PC

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Complete blood count

Complete blood count – a laboratory test that allows you to determine the concentration of hemoglobin, the number of erythrocytes, hematocrit and erythrocyte indices (MCV, RDW, MCH, MCHC), the number of leukocytes and platelets, additionally the number of reticulocytes. And also a general clinical blood test is not complete without microscopy of the leukocyte formula and the determination of a non-specific indicator of inflammation – the erythrocyte sedimentation rate (ESR).

Leukocyte formula is the percentage of different types of leukocytes – blasts, promyelocytes, myelocytes, metamyelocytes, stab neutrophils, segmented neutrophils, eosinophils, basophils, monocytes, lymphocytes. In addition, the doctor, using microscopy of a stained blood smear, describes various cell changes, for example, changes in erythrocytes (anisocytosis, poikilocytosis, microcytosis, macrocytosis, hypochromia, hyperchromia, etc. ). The method is indispensable in the diagnosis of hematological diseases, as it allows to detect and describe blasts and young cells, to suspect leukemia.

Blasts, promyelocytes, myelocytes, metamyelocytes are normally not found in peripheral blood.

The calculation of the leukocyte formula is carried out not only for the purpose of diagnosing blood diseases, but also to identify changes characteristic of infectious, inflammatory diseases, and is also used to assess the severity of the condition and the effectiveness of the therapy.

Reticulocytes are juvenile forms of erythrocytes that contain a granular-filamentous substance that can be detected by special staining. Reticulocytes are formed in the bone marrow from normoblasts, where they mature for 1–2 days, after which they enter the peripheral blood. The time of maturation of reticulocytes to mature erythrocytes in the peripheral blood is about 2 days. The number of reticulocytes in the blood reflects the regenerative properties of the bone marrow and is used for differential diagnosis of the type of anemia.

It is advisable to use “reticulocyte index” to assess the severity of anemia:

% reticulocytes x hematocrit of the patient / 45 x 1.85

(where: 45 is normal hematocrit, and 1.85 is the number of days required for new reticulocytes to enter the peripheral blood).

    • index < 2 - evidence of a hypoproliferative component of anemia;
    • index> 2 – 3 – evidence of an increase in the formation of red blood cells.

    Erythrocyte sedimentation rate (ESR) – non-specific indicator of inflammation. In acute inflammatory and infectious processes, a change in the erythrocyte sedimentation rate is noted 24 hours after an increase in temperature and an increase in the number of leukocytes. In chronic inflammation, an increase in ESR is due to an increase in the concentration of fibrinogen and immunoglobulins. The determination of ESR in dynamics, in combination with other tests, is used to monitor the effectiveness of the treatment of inflammatory and infectious diseases.