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Hematocrit hct low: Test, High, Low, and Normal

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Hemoglobin and Hematocrit – Clinical Methods

Definition

Hemoglobin (Hb) is the protein contained in red blood cells that is responsible for delivery of oxygen to the tissues. To ensure adequate tissue oxygenation, a sufficient hemoglobin level must be maintained. The amount of hemoglobin in whole blood is expressed in grams per deciliter (g/dl). The normal Hb level for males is 14 to 18 g/dl; that for females is 12 to 16 g/dl. When the hemoglobin level is low, the patient has anemia. An erythrocytosis is the consequence of too many red cells; this results in hemoglobin levels above normal.

The hematocrit measures the volume of red blood cells compared to the total blood volume (red blood cells and plasma). The normal hematocrit for men is 40 to 54%; for women it is 36 to 48%. This value can be determined directly by microhematocrit centrifugation or calculated indirectly. Automated cell counters calculate the hematocrit by multiplying the red cell number (in millions/mm3) by the mean cell volume (MCV, in femtoliters). When so assayed, it is subject to the vagaries inherent in obtaining an accurate measurement of the MCV (see Chapter 152).

Both the hemoglobin and the hematocrit are based on whole blood and are therefore dependent on plasma volume. If a patient is severely dehydrated, the hemoglobin and hematocrit will appear higher than if the patient were normovolemic; if the patient is fluid overloaded, they will be lower than their actual level. To assess true red cell mass, independent radionuclide evaluation of the red cells and plasma (by 51Cr and 131I respectively) must be performed.

Technique

Hematocrit

If the hematocrit must be determined quickly, as is often the case when a patient hemorrhages, it may be necessary to measure the hematocrit directly without the use of an automated counter. The materials needed are:

  • Lancets

  • Alcohol prep pads

  • Gauze pads

  • Microhematocrit tubes (heparinized)

  • Sealant (“Seal-Ease,” “Crit-Seal,” etc)

  • Microhematocrit centrifuge

  • Microhematocrit reader

  • If venipuncture is required: tourniquet, syringe, tube containing anticoagulant (EDTA, citrate)

For hematocrits obtained by fingerstick, wipe the fingertip pad of the fourth finger of the nondominant hand with the alcohol prep pad. Make certain the area is allowed to dry. Prick the fingertip with the lancet. Place the hematocrit tube near the incision site and allow the blood to flow via capillary action into the hematocrit tube until it is two-thirds to three-fourths full or to a predesignated mark on the tube. Avoid “milking” the finger if possible; this causes the expression of tissue fluids and may result in a falsely low hematocrit. Always fill at least three tubes. For hematocrits obtained by venipuncture, draw a sample of blood into the tube containing anticoagulant and mix well. Dip the hematocrit tube into the blood and allow the blood to rise to the desired two-thirds to three-quarters level. Because blood cells naturally sediment, a prior thorough mixing of the blood in the tube is necessary to ensure accurate reading.

After cleaning the outside of the hematocrit tubes of excess blood, invert the tube slowly so that the blood migrates just short of the bottom end of the tube. Seal the bottom of the tube with sealant. Make certain that little or no air is interspersed in the column of blood. If the seal is incomplete, leakage will occur during centrifugation and false readings will be obtained.

Place the tubes in a microhematocrit centrifuge and spin for 3 to 5 minutes at high speed. A shorter spin will not allow for complete sedimentation.

Using either a hematocrit reader or any ruled apparatus, measure the length of the column of the packed red cells and divide it by the length of the whole column of blood (cells and plasma), as in . To obtain the hematocrit, multiply this number by 100%. Average all readings obtained from the different microhematocrit tubes.

Figure 151.1

Microhematocrit tube after sedimentation. The hematocrit is a ratio of the packed cells to total volume.

Example: If the column of packed red cells measures 20 mm and the whole blood column measures 50 mm, the hematocrit is 20/50 = 0.4 or (0.4 × 100%) = 40%.

Hemoglobin

Hemoglobin determinations will usually be performed by an automated cell counter from a tube of well-mixed EDTA-anticoagulated blood filled to a predetermined level. In this assay, all forms of hemoglobins are converted to the colored protein cyanomethemoglobin and measured by a colorimeter. An inadequate sample, whether due to insufficient volume or inadequate anticoagulation, may give false readings. If it is necessary to determine the level of anemia quickly, the hematocrit is an easier, more convenient test.

Hemoglobin Electrophoresis

Hemoglobin electrophoresis measures the mobility of hemoglobin in an electric field; it can therefore detect only those abnormalities in hemoglobin that alter the charge. Electrophoretic mobilities are affected by pH and by the medium in which the test is conducted. Screening tests typically use a hemolysate of anticoagulated blood electrophoresed on cellulose acetate at pH 8.6 to 8.8. If necessary, a further electrophoresis in starch gel at pH 6.2 to 6.8 is performed. At that stage, the work will usually be performed by a specialized laboratory.

Hemoglobin electrophoresis will not readily assess situations where there are neutral amino acid substitutions or where the hemoglobin is normal but the constituent chains are not produced in equal numbers (thalassemias). The diagnosis of alpha thalassemia of a mild to moderate degree cannot be made by hemoglobin electrophoresis; the diagnosis of beta thalassemia may be made by inference from an increase in the Hb A2.

A standard electrophoresis would look like .

Figure 151.2

A standard hemoglobin electrophoresis (cellulose acetate, pH 8.6).

Basic Science

The molecular weight of hemoglobin is approximately 64,500 daltons. Hb is composed of two pairs of dissimilar chains, α and β, each defined by a specific amino acid sequence and incorporating an iron-containing heme group. Two α–β dimers combine to form a hemoglobin tetramer. This allows for the “heme–heme” interaction necessary for effective oxygen uptake (deoxyhemoglobin → oxyhemoglobin) and delivery (oxyhemoglobin → deoxyhemoglobin). The oxygen affinity of hemoglobin is a function of this heme–heme interaction and of pH (Bohr effect), and is a measure of how many hemoglobin molecules have oxygen bound to them for a given level of oxygen tension. In a normal individual the major hemoglobin is Hb A, constituting approximately 97% of the total hemoglobin. Variations and/or amino acid substitutions in these chains exist. Some are deleterious to the normal function of hemoglobin, whereas others may have relatively normal oxygen affinity and stability. Hemoglobins containing different types of chains make up the remainder of the hemoglobin content in red cells (α2δ2 = Hb A2 approximately 2%; α2γ2 = Hb F approximately 1%).

Substitutions in the normal hemoglobin amino acid sequence may result in hemoglobins that have different sub-unit interactions and varying affinities for oxygen. For example, a substitution of the sixth amino acid on the beta chain causes Hb S, or sickle hemoglobin. Hb S has a lower oxygen affinity and surrenders its oxygen more readily. Hb F, a normal minor hemoglobin constituent, has a higher oxygen affinity.

If the oxygen dissociation curve is abnormal, the body will adjust the hemoglobin level to ensure adequate oxygen distribution to the tissues. Thus in a rare disease like hemoglobin Hotel Dieu, the difficulty in extracting oxygen from a variant hemoglobin with increased oxygen affinity could result in a lack of oxygen for the tissues (tissue hypoxia) and a compensatory erythrocytosis. The smaller fraction of oxygen released from the hemoglobin is thereby offset by the increased number of hemoglobin molecules. Similarly, in sickle cell anemia, the decreased oxygen affinity allows these patients more tissue oxygen at any given hemoglobin level.

Clinical Significance

Many anemias are detected by routine laboratory screening performed before the patient is symptomatic. When the patient does have symptoms from an abnormality in the hemoglobin level, the symptoms are often a nonspecific weakness or fatigue. The only finding on physical examination may be pallor; additional changes in the nail beds (such as spooning), glossitis (red tongue), or hepatosplenomegaly (enlarged liver or spleen) may give a clue to the etiology of the anemia. Symptoms are usually related to the level of hemoglobin, its abruptness of onset and its duration. A patient with pernicious anemia may feel well at the same level of hemoglobin that would cause severe weakness in a patient with acute gastrointestinal hemorrhage. This is due to volume compensation by plasma and shifts in the oxygen dissociation curve which occur over time.

When first confronted with an abnormal hemoglobin or hematocrit level, the next step is to assess the red cell indices (see Chapter 152), peripheral smear (Chapter 155), and the reticulocyte count (Chapter 156) in light of the patient’s history and physical examination.

References

  1. Adamson JW, Finch CA. Hemoglobin function, oxygen affinity and erythropoietin. Annu Rev Physiol. 1975;37:351. [PubMed: 235878]
  2. Bunn HF. Hemoglobin I. Structure and function. In: Beck WS, Hematology. Cambridge, MA: MIT Press, 1981;129.

Definition, low levels, high levels, and more

Hematocrit is the percentage of red blood cells in a person’s blood. Low red blood cell levels indicate conditions such as anemia. High red blood cell levels could signal polycythemia, which can increase a person’s chance of developing a blood clot.

If a person feels tired, dizzy, or short of breath, a doctor may want to test their hematocrit levels to see if those levels fall into a normal range or not.

Both high and low hematocrit levels can be detrimental to a person’s health, and can result from a variety of conditions and lifestyle factors.

Read on to learn more about what this measure of red blood cell volume means, symptoms of abnormal levels, and what low and high levels might indicate.

Hematocrit is a measure of the percentage of red blood cells in the body. For example: if a person has 50 milliliters (ml) of red blood cells in 100 ml of blood, their hematocrit level is 50%.

Red blood cells transport oxygen around the body and give blood its characteristic red color. In addition to oxygen, they also contain hemoglobin, a protein that binds to oxygen molecules. This allows red blood cells to pick up hemoglobin from the lungs and deliver it throughout the body.

Having an adequate amount of red blood cells is essential to keep the body’s processes running smoothly.

However, the percentage of red blood cells in someone’s blood can change depending on a variety of lifestyle factors and even environmental changes. According to research, red blood cell counts tend to increase at high altitude.

Exercise, particularly strength training, may also affect hematocrit levels. A 2018 study found that females who participated in 16 weeks of strength exercise had lower levels at the end compared when they started. However, the study had a small sample size of 26 middle-aged, sedentary Turkish women. This means that these findings aren’t necessarily representative of a wider population.

There are many conditions that can affect red blood cell production or their life cycle. This can make it difficult for a medical professional to diagnose these conditions. A doctor will use a hematocrit test to confirm whether a person’s red blood cell count is affecting a health condition.

Doctors usually test hematocrit levels as part of a complete blood count (CBC).

A CBC is composed of a range of tests, and may include:

  • red blood cell count
  • reticulocyte count (young red blood cells)
  • an analysis of hemoglobin levels
  • an analysis of red blood cells, including size and shape
  • white blood cell tests
  • platelet tests

A doctor will also take into consideration a person’s sex, race, and age. It is important to note that certain blood-related conditions, such as sickle-cell anemia, affect particular demographic groups at higher rates.

Learn more about sickle cell anemia in African Americans here.

Dehydration can raise hematocrit levels, so this test is useful if a doctor suspects severe dehydration is the cause of a person’s symptoms.

A doctor may request frequent hematocrit tests to monitor the effect of chemotherapy on person’s bone marrow.

Normal hematocrit levels are:

Newborn babies have high hematocrit levels that gradually decrease as they get older.

If a person has recently received a blood transfusion, it may affect their results. Additionally, pregnant individuals may have lower levels than usual because the body increases its blood volume during pregnancy.

Other factors may push levels into a higher range, such as smoking and chronic obstructive pulmonary disease (COPD).

When a person has low hematocrit levels they tend to present with the following symptoms:

  • pale complexion
  • weakness
  • fatigue
  • low energy
  • trouble breathing
  • irregular heartbeat
  • cold hands or feet

These symptoms also indicate anemia, a condition where hemoglobin levels are lower than normal. Hemoglobin is a protein found in red blood cells that carries oxygen around the body.

Mild anemia is treatable, and it is particularly common in women. Severe anemia could signal a more serious underlying health condition that requires more extensive treatment.

Doctors associate anemia with several health conditions that include:

Nutrient deficiency

A person may lack B12, folate, or iron in their diet.

Learn more about how nutrient deficiency anemia is diagnosed and treated.

Chronic bleeding

This commonly occurs due to digestive tract ulcers, which are sores caused by the bacteria H.pylori or chronic use of anti-inflammatory medications such as ibuprofen, other non-steroidal anti-inflammatory drugs (NSAIDs), and aspirin. Many women also experience excessive blood loss from heavy menstrual bleeding.

Bone marrow disorder

This includes aplastic anemia, which damages stem cells in bone marrow.

Cancer

These are cancers that spread to bone marrow, such as leukemia and lymphoma.

Learn more about bone marrow cancers here.

Kidney failure

Kidney disease can lower the production of red blood cells, reducing hematocrit levels.

Thalassemia

When a person has this condition, their body does not produce enough hemoglobin.

Learn more about thalassemia here.

Sickle cell anemia

This condition changes the shape of red blood cells. These cells die earlier than normal, and they also clump together, which impairs blood flow.

Learn more about sickle cell anemia here.

Autoimmune disease

Conditions like rheumatoid arthritis and lupus may reduce red blood cell count.

Learn more about autoimmune diseases here.

When a person has high hematocrit levels they tend to present with these symptoms:

  • flushed skin
  • dizziness
  • vision problems
  • headaches
  • enlarged spleen

These symptoms signal polycythemia, a condition where the body produces too many red blood cells. This means blood is thicker and clots more easily.

Doctors cannot cure polycythemia, so treatment tends to focus on symptom management. The main goal is to avoid stroke and deep vein thrombosis (DVT), which is a blood clot usually occurring in a deep vein in the leg.

In some cases, dehydration causes polycythemia. When a person does not drink enough, their plasma levels drop, and this increases the proportion of red blood cells in their blood volume. A person can lower their red blood cell count by rehydrating.

Some conditions that can cause high hematocrit levels include:

Lung or pulmonary disease

When the lungs cannot absorb oxygen effectively and oxygen levels drop, the body compensates by making more red blood cells. One common pulmonary disease causing this is COPD.

Learn more about COPD here.

Heart disease

If the structure of a person’s heart reduces its ability to pump blood around the body, it can no longer sustain vital organs with oxygen. To try and overcome the oxygen deficit the body produces more red blood cells.

Learn more about heart disease here.

Kidney cancer

Sometimes kidney cancer cells create more erythropoietin. Erythropoietin is a hormone that tells the bone marrow to create more red blood cells.

Learn more about kidney cancer here.

Genetic disease

The JAK2 gene, which controls the number of blood cells made in the bone marrow, can affect certain conditions. When someone has a mutated JAK2 gene, the body could make a protein that signals the bone marrow to create more red blood cells than it needs.

Learn more about genetic disorders here.

A person should speak with a doctor if they are experiencing any of the symptoms listed above that could be a sign of high or low hematocrit levels, including fatigue, weakness, vision problems, and dizziness.

These symptoms can also indicate an underlying condition, so it is important that a person contact a doctor in a timely manner to prevent future complications.

If a person is receiving chemotherapy treatment, a doctor should perform regular hematocrit tests to monitor bone marrow health.

Hematocrit is the percentage of blood cells in a person’s blood volume. A doctor may choose to test an individual’s hematocrit level due to certain symptoms.

A low hematocrit level means the are too few red blood cells in the body. In these cases, a person may experience symptoms that signal anemia. Common symptoms include fatigue, weakness, and low energy.

If a person has too many red blood cells, they have a high hematocrit level. A person may experience dizziness and headaches, which can be a sign of the condition polycythemia.

Demographic and lifestyle factors can influence a person’s hematocrit levels. For example, males tend to have higher levels than females. Pregnant individuals can experience a decrease in hematocrit levels, and strength training may also reduce levels.

There are also a number of health conditions that can cause hematocrit levels outside the normal range. Excessive bleeding, thalassemia, and kidney disease are causes of low levels. COPD and sickle cell anemia can cause high levels.

Hematocrit Test | HCIT | CRIT

what is haematocrit (hct / crit)?

The Haematocrit (Ht or HCT) or packed cell volume is the ratio of blood volume occupied by red blood cells. It is an essential component of an individuals blood count, along with haemoglobin concentration, white blood cell count, and platelet count. 

Haematocrit is ascertained by spinning heparinized blood in a capillary tube. Haematocrit increases when the amount of red blood cells increase or when the volume of plasma is reduced, like in dehydration. Low Haematocrit indicates the body reduced production of red blood cells or when large amounts of blood is lost due to bleeding indicating anaemia.

low haematocrit

Low Haematocrit simply means that the red blood cells is below the normal limits for that person’s age, gender and weight. The main low haematocrit causes are as follows;

  • Bleeding due to ulcers, trauma, colon cancer and internal building.
  • Destruction of red blood cells in diseases like sickle cell anaemia and enlarged spleen.
  • Decreased production of red blood cells due to various factors like bone marrow suppression, cancer and as reaction to certain types of medication.
  • Poor nutrition leading to low levels of Iron, B12 and folate is one of the chief contributing low haematocrit cause.
  • Overhydration.

Low Haematocrit Symptoms

The common low haematocrit symptoms includes;

  • Shortness of breath
  • Palpitation
  • Dizziness
  • Fatigue
  • Low energy levels

high haematocrit

A high Haematocrit level indicates to the higher percentage of red blood cells in the blood, in regards to the Haematocrit normal value for that person’s age, sex and weight. The primary high haematocrit causes are as follows;

  • Dehydration
  • Low oxygen level
  • Genetic problems like congenital heart disease
  • polycythemia Vera
  • Erythrocytosis
  • COPD
  • Chronic Sleep Apnoea
  • Pulmonary Embolism

High Haematocrit Symptoms

The main high haematocrit symptoms are as follows;

  • Itchiness
  • Headache
  • Blood clot formation
  • Easy bruising
  • Fatigue
  • Dizziness

what is haematocrit blood test?

Haematocrit blood test, also called Packed – cell volume test (PCV Test), is a simple blood test that ascertains what percentage of the whole blood does the erythrocytes or red blood cells consists of. The blood is composed of erythrocytes, red blood cells, leukocytes or white blood cells and thrombocytes or platelets, all these together form 45% of the blood while the rest of the 55% of blood is composed of plasma, and as such it is imperative to find out what percentage of erythrocytes (vital oxygen carrying cells) is present in the blood.

Too low or too high percentage of erythrocytes could be indicative of various health issues like anaemia being one of them.

Haematocrit Normal Value

Haematocrit normal range varies and is depended upon varied factors like gender, weight and age. As such the Haematocrit normal range for men is between 40% to 54% of erythrocytes and for women the Haematocrit normal range is between 37% to 48%.  

why get tested?

The Haematocrit test is generally ordered along with the complete blood count (CBC). The test helps in the assesment of:

  • Anemia (Condition in which erythrocytes are reduced in number or volume or are deficient in hemoglobin)
  • polycythemia ( A disease state in which the proportion of blood volume that is occupied by red blood cells increases)
  • Response to treatment of anemia or polycythemias
  • Dehydration
  • Blood transfusion decisions for severe symptomatic anemia’s
  • The effectiveness of those transfusions

reason to take hematocrit (hct / crit) test

Symptoms associated and observed are:

  • Feeling of tiredness or weakness (fatigue)
  • Lack of energy headache
  • Dizziness
  • Feeling of cold or numbness in hands and/or feet
  • Pale complexion
  • Shortness of breath
  • Fast or irregular heartbeat
  • Chest pain
  • Excessive loss of water Brittle nails

preparations needed for hematocrit (hct / crit) test

Preparatory instructions before the test *:

No Fasting Required.

No other special preparations required.

sample required?

Specimen type: EDTA (Blood Sample)

Specimen collection procedure: Venipuncture – Collection of blood from a vein, usually from the arm.

how can we help?

You no longer need to break a sweat to get your haematocrit test, by looking around for reliable pathological labs and then waiting to get tested, just give us a call and our representative phlebotomist would be there at your home at a time and day of your convenience to collect the required blood sample.

We would also home deliver your haematocrit test reports to you. Portea is the leading at home healthcare services provider with highly reliable and certified healthcare services ranging from doctor’s consultation, nursing services to therapies and lab tests. So you can trust us with providing you the best home haematocrit test, so you can spend your time with a loved one rather running from pillar to post.   

Understanding results ofHematocrit (HCT / CRIT)

35 – 45 % 6 Years. 1 month – 12 Years
34 – 40 % 2 Years – 6 Years
30 – 38 % 6.5 months – 1 Yr. 11 months
30 – 40 % 3 months – 6 months
28 – 42 % 2 months – 2.5 months
31 – 71 % Day 14 – Day 29
33 – 53 % 1 months – 1.5 months
42 – 66 % Day 7 – Day 13
45 – 67 % Day 3 – Day 6
36 – 46 % Adolescent Female
45 – 75 % Day 1 – Day 2
37 – 49 % Adolescent Male
40 to 54% Male
35 to 47% Female

‘*A Reference range is a set of values which helps the healthcare professional to interpret a medical test. It may vary with age, gender, and other factors. Reference ranges may also vary between labs, in value & units depending on instruments used and method of establishment of reference ranges’

Hematocrit (HCT) – LiveSmart

Overview

Hematocrit is the proportion of your total blood volume that is composed of red blood cells. A hematocrit (HCT) test indicates whether you have too few or too many red blood cells — conditions that can occur as the result of certain diseases. Red blood cells, or erythrocytes, transport oxygen throughout your body.

A hematocrit test is part of a complete blood count (CBC). The proportion of red blood cells compared with all blood cells may help your doctor make a diagnosis or monitor your response to a treatment.


What a lower than normal hematocrit may indicate

  • An insufficient supply of healthy red blood cells (anemia)
  • A large number of white blood cells — usually a very small portion of your blood — due to long-term illness, infection, leukemia, lymphoma or other disorders of white blood cells
  • Vitamin or mineral deficiencies: Nutrition deficiencies of iron, copper, folic acid, vitamin B6, or vitamin B12
  • Recent or long-term blood loss
  • Deficiency of a hormone called erytropoietin  (caused by kidney disease)
  • Malnutrition

 

What a high hematocrit means

  • Dehydration (such as from severe diarrhea)
  • A disorder, such as polycythemia vera, that causes your body to produce too many red blood cells
  • Lung or heart disease. If the body senses low oxygen levels, it will make more red blood cells in an effort to increase the amount of oxygen in the blood.
  • Cigarette smoking
  • Kidney tumor

How is a low or high hematocrit treated?

The treatment of high or low hematocrit depends on the underlying cause, the hematocrit level, and the overall health status of the individual. Some patients with very low hematocrits may require intravenous iron or complete blood count. Some patients with very high hematocrits due to diseases, such as polycythemia rubra vera, may require blood letting.

The doctor will decide when medication or procedures are necessary for each particular individual. In general, abnormal hematocrit values are monitored by doctors with routine blood testing.

Hematocrit Test – Request A Test

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Hematocrit Blood Test

Hct, PCV, Packed Cell Volume

Test Code: 005058

Specimen Type: Blood

Description:

Hematocrit Blood Test

This test measures Hematocrit in a blood sample.  Hematocrit is the percentage of blood which is made up of red blood cells (RBC).  Red blood cells are produced in the bone marrow and carry oxygen throughout the body.  Typically the body continually produces new red blood cells to replace ones that are lost through bleeding or have aged and broken down.  Low hematocrit is often indicative of anemia and can be caused by excessive blood loss, nutritional deficiencies such as iron or B12, bone marrow disorders or kidney damage.  Higher than normal hematocrit can be caused by dehydration, lung disease, heart disease or kidney tumors.

A hematocrit test is often done as part of routine general health testing.  It is also ordered when a person is experiencing symptoms of anemia such as fatigue, lack of energy, paleness, shortness of breath or fainting.  This test can also be used to monitor treatment for anemia. 

Hematocrit is also part of a Complete Blood Count (CBC). 

Turnaround time for the Hematocrit test is typically 1 business day.

Note: Result turn around times are an estimate and are not guaranteed. Our reference lab may need additional time due to weather, holidays, confirmation/repeat testing, or equipment maintenance.

Requirements:

The Hematocrit test has no fasting requirements.

Categories:

Hematocrit Blood Test

Hct, PCV, Packed Cell Volume

Test Code: 509

Specimen Type: Blood

Description:

Hematocrit Blood Test

This test measures Hematocrit in a blood sample.  Hematocrit is the percentage of blood which is made up of red blood cells (RBC).  Red blood cells are produced in the bone marrow and carry oxygen throughout the body.  Typically the body continually produces new red blood cells to replace ones that are lost through bleeding or have aged and broken down.  Low hematocrit is often indicative of anemia and can be caused by excessive blood loss, nutritional deficiencies such as iron or B12, bone marrow disorders or kidney damage.  Higher than normal hematocrit can be caused by dehydration, lung disease, heart disease or kidney tumors.

A hematocrit test is often done as part of routine general health testing.  It is also ordered when a person is experiencing symptoms of anemia such as fatigue, lack of energy, paleness, shortness of breath or fainting.  This test can also be used to monitor treatment for anemia. 

Hematocrit is also part of a Complete Blood Count (CBC).

Turnaround time for the Hematocrit test is typically 1 business day.

Note: Result turn around times are an estimate and are not guaranteed. Our reference lab may need additional time due to weather, holidays, confirmation/repeat testing, or equipment maintenance.

Requirements:

The Hematocrit test has no fasting requirements.

Categories:

Hct, PCV, Packed Cell Volume

Test Code: 005058

Specimen Type: Blood

Description:

Hematocrit Blood Test

This test measures Hematocrit in a blood sample.  Hematocrit is the percentage of blood which is made up of red blood cells (RBC).  Red blood cells are produced in the bone marrow and carry oxygen throughout the body.  Typically the body continually produces new red blood cells to replace ones that are lost through bleeding or have aged and broken down.  Low hematocrit is often indicative of anemia and can be caused by excessive blood loss, nutritional deficiencies such as iron or B12, bone marrow disorders or kidney damage.  Higher than normal hematocrit can be caused by dehydration, lung disease, heart disease or kidney tumors.

A hematocrit test is often done as part of routine general health testing.  It is also ordered when a person is experiencing symptoms of anemia such as fatigue, lack of energy, paleness, shortness of breath or fainting.  This test can also be used to monitor treatment for anemia. 

Hematocrit is also part of a Complete Blood Count (CBC). 

Turnaround time for the Hematocrit test is typically 1 business day.

Note: Result turn around times are an estimate and are not guaranteed. Our reference lab may need additional time due to weather, holidays, confirmation/repeat testing, or equipment maintenance.

Requirements:

The Hematocrit test has no fasting requirements.

Categories:

Hematocrit Blood Test

Hct, PCV, Packed Cell Volume

Test Code: 509

Specimen Type: Blood

Description:

Hematocrit Blood Test

This test measures Hematocrit in a blood sample.  Hematocrit is the percentage of blood which is made up of red blood cells (RBC).  Red blood cells are produced in the bone marrow and carry oxygen throughout the body.  Typically the body continually produces new red blood cells to replace ones that are lost through bleeding or have aged and broken down.  Low hematocrit is often indicative of anemia and can be caused by excessive blood loss, nutritional deficiencies such as iron or B12, bone marrow disorders or kidney damage.  Higher than normal hematocrit can be caused by dehydration, lung disease, heart disease or kidney tumors.

A hematocrit test is often done as part of routine general health testing.  It is also ordered when a person is experiencing symptoms of anemia such as fatigue, lack of energy, paleness, shortness of breath or fainting.  This test can also be used to monitor treatment for anemia. 

Hematocrit is also part of a Complete Blood Count (CBC).

Turnaround time for the Hematocrit test is typically 1 business day.

Note: Result turn around times are an estimate and are not guaranteed. Our reference lab may need additional time due to weather, holidays, confirmation/repeat testing, or equipment maintenance.

Requirements:

The Hematocrit test has no fasting requirements.

Categories:

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Understanding your Pets Blood Test Results — Leelanau Veterinary Care

Leelanau Veterinary Care

Understanding your Pet’s Blood Work Results

Blood tests help a doctor determine the causes of illness accurately, safely and quickly and help to monitor the progress of medical treatments and conditions. The following guide explains common test results to help you better understand your pet’s health and the care recommendations.

Complete Blood Count (CBC)

A CBC gives the information on hydration status, anemia, infection, the blood’s clotting ability, and the ability of the immune system to respond. This test is essential for pets that are not feeling well with symptoms such as fever, vomiting, diarrhea, weakness, pale gums, loss of appetite, or just not feeling well in general. If your pet needs surgery, a CBC can help to detect bleeding disorders and other unseen abnormalities.

HCT/PCV (hematocrit/packed cell volume) measures the percentage of your pet’s red blood cells. This test helps to detect anemia, bleeding episodes, and dehydration. Normal in a cat is above 28 and in dogs above 35.

 HGB and MCHC (hemoglobin and mean corpuscular hemoglobin concentration) are the oxygen carrying pigments of red blood cells.

RETICS (reticulocytes) are immature or new red blood cells. High levels indicate regenerative anemia or signs of recent bleeding.

 WBD (white blood cell count) measures the body’s immune and infection fighting cells. Increases or decreases indicate certain diseases such as cancer/leukemia or infections.

 NEU, LYM, MONO (neutrophils, lymphocytes, monocytes) are specific types of white blood cells which fight infection. If these are elevated it can indicate an infection or cancer.

 EOS (eosinophils) are a specific type of white blood cells the if elevated may indicate allergic or parasitic conditions.

PLT (platelet count) measures the cells that help form blood clots and control bleeding.

Blood Chemistry

These are common blood serum tests that evaluate organ function, electrolyte status, hormone levels, and more. These tests are important in evaluating older pets, pets that are ill, pets receiving long-term medications, and pets undergoing sedation or anesthesia. The tests are also very important as a regular screening evaluation of your pet’s health status.

ALB  (albumin) is a serum protein that helps evaluate hydration, hemorrhage, and intestinal, liver, and kidney disease.

ALKP (alkaline phosphatase) elevations may indicate liver damage, Cushing’s disease, and active bone growth in young pets. This test is significant in cats especially. A slight elevation may be normal in some pets, especially older pets.

ALT (alanine aminotransferase) is a sensitive indicator of active liver damage but doesn’t indicate the cause. A slight elevation may be normal in some pets, especially older pets.

 AMYL (amylase) elevations show pancreatitis or kidney disease.

BUN (blood urea nitrogen) indicates kidney function. An increased blood level is called azotemia and can be caused by kidney, liver, and heart disease, urethral obstruction shock and dehydration.

CA (calcium) deviations can indicate a variety of diseases. Tumors, hyperparathyroidism, kidney disease, and low albumin are just a few of the conditions that alter serum calcium.

CHOL (cholesterol) is used to supplement diagnosis of hypothyroidism, liver disease, Cushing’s disease, and diabetes mellitus,

 CREA (creatinine) indicates kidney function. This test helps distinguish between kidney and non-kidney causes of elevated BUN. An indicator of kidney function.

 GLOB (globulin) is a blood protein that often increases with chronic inflammation and certain disease states.

GLU (glucose) is a blood sugar. Elevated levels may indicate diabetes mellitus. Low levels can cause collapse, seizures, or coma. When a pet is nervous, the blood glucose can be normally elevated. In dogs blood glucose should be under 180 and in cats under 250.

 K (potassium) is an electrolyte lost with vomiting, diarrhea, or excessive urination. Increased levels may indicate kidney failure, Addison’s disease, dehydration, and urethral obstruction. Excessively high levels can lead to cardiac arrest.

 AML (amylase) is an enzyme that may indicate infection or inflammation of the pancreas (pancreatitis) in dogs.

 Na (sodium) is an electrolyte lost with vomiting, diarrhea, and kidney and Addison’s disease. This test also helps indicate hydration status.

 PHOS (phosphorus) elevations are often associated with kidney disease, hyperthyroidism, and bleeding disorders. An elevation in this value also may indicate active bone growth in young dogs.

TBIL (total bilirubin) elevations may indicate liver or blood hemolytic disease. This test helps identify bile duct problems and certain types of anemia.

 TP (total protein) can indicate your pet’s hydration status and provides additional information about the liver, kidneys, and infectious diseases.

 T4 (thyroxine) is a thyroid hormone. Decreased levels often signal hypothyroidism in dogs, while high levels indicate hyperthyroidism in cats.

 

 

 

 

Why Is My Dog Or Cat’s Blood Hematocrit (=Hct=PCV) Low Or High?

When Low = Anemia

Ron Hines DVM PhD

To see what normal blood and urine values are, go here

For an explanation of causes of most abnormal blood and urine tests, go here 

To see how tests are grouped, go here

Read this article as well 

Your Pet’s Hematocrit = Hct = PCV = Packed Cell Volume 

When your dog or cat’s blood is drawn up into a thin glass tube and then spun in a centrifuge, the height of the column of red cells that have spun to the bottom of the capillary tube is its hematocrit.

Normally, about half of the tube then consists of the pet’s straw-colored blood serum at the top, with packed red blood cells at the bottom and a thin layer of white blood cells just above them (the buffy coat). If the red lower portion is anything less than about 40% of the total, your pet is anemic. The next test, blood hemoglobin content, measures the actual amount of the blood carrying element, hemoglobin, in your pet’s blood. Low hematocrits almost always lead to low hemoglobin levels. The only exception is when the fewer-than-normal red blood cells are larger than normal (a macrocytic anemia or MCV ).

Reasons Why Your Pet Might Have A Low Hematocrit:

There are too many causes of anemia for me to mention. Here are some of the more common ones: Hemorrhage, including, hemorrhage into the intestinal tract (such as due to parvovirus infection in dogs or coccidiosis infection in kittens). Blood sucking parasites such as hookworms in dogs or in cats. Heavy flea infestation,

Other than blood loss through the intestines blood loss from wounds to the body or within the body after trauma is another common cause of a low PCV .

Blood parasites (such as haemobartonella/mycoplasmosis in cats. Babesiosis , ehrlichia and anaplasmosis in dogs can be responsible for a low hematocrit.

Autoimmune anemias, where red blood cells are destroyed by antibodies generated by the pet’s own body is another fairly common cause of anemia in dogs.

Rupture of a major blood vessel, toxic bone marrow suppression, atypical responses to antibiotics and other medicines and bone marrow tumors can also be responsible for a  low hematocrit.

In older dogs and cats, chronic kidney disease is a common cause of anemia. In those cases toxins that build up supress the formation of new red blood cells. That is called an aplastic anemia and a low reticulocyte count helps identify it. Chronic liver disease, malnutrition and vitamin/mineral deficiencies (B12 , Iron, folate) can be responsible for a low hematocrit as well. Those deficiencies are often associated with the chronic intestinal inflammation present in diseases such as IBD ( in your cator in your dog). triad disease in cats and the intestinal form of lymphoma in cats also commonly lead to anemia.

Heavy tick and flea infestation can also be the cause of a low hematocrit and anemia. But anemia in parasitized pets is more likely to be caused by the blood parasites those ticks and fleas carry – compounded by the general stress that animals living in sub-standard conditions endure.

Reasons Why Your Dog And Cat Might Have A High Hematocrit:

The most common cause in dogs and cats is dehydration. Diarrhea and vomiting are the most common causes of dehydration. The second most common cause is probably a lack of interest in drinking due to ill health or the unavailability of water. Puppies and kittens are more susceptible to dehydration than mature pets. That is because of their higher metabolic rate.  

Persistent fever is another possible cause of dehydration. 

Diuretic medications such as furosemide (Lasix®) can cause dehydration as well.

On very rare occasions, your pet could actually be producing too many red blood cells (polycythemia). That rare condition can occur when kidney tumors produce erythropoietin (a stimulant to RBC production) or due to causes still unknown.

It is normal for greyhound dogs (and perhaps other sight hounds (ref) to have high hematocrits. Polycythemia can also be a response to living at high altitudes or chronic lung disease – both of which limit your pet’s ability to absorb oxygen.

Complementary Tests:

CBC /WBC and blood chemistry panel (paying particular attention to increased sodium [as evidence of dehydration] ) MCV,  MCH and MCHC), urinalysis, reticulocyte count

DxMe

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90,000 Analysis for Hematocrit – what is it, what does

depend on

Hematocrit – what is it, what does

depend on

Analysis for hematocrit gives data on the ratio of the volume of red blood cells to the total volume of blood, occasionally this indicator means the ratio of the volume of all formed elements to the total volume. There is no particular difference between the interpretations, 99% of the volume of blood cells is in red cells. More often, the hematocrit is recorded as a percentage of the total volume, less often as a ratio of the volume of cells to the total volume of blood.

This indicator is determined as part of a complete blood count. It refers to secondary, calculated on the basis of data on the number of red blood cells. Occasionally, a direct measurement of hematocrit is carried out by centrifuging the sample taken. This procedure allows you to separate the plasma from the corpuscles and directly measure this indicator.

Indications and preparation for analysis

The indications for the analysis of hematocrit are symptoms indicating the development of anemia or other diseases of the blood, hematopoietic system.These include:

  • Pallor or yellowness of the skin
  • Enlargement of the spleen, liver
  • Changes in the size of the lymph nodes
  • Digestive disorders
  • Problems with the skin and hair (rashes, ulcers on the mucous membranes, hair loss or brittleness)

In addition to detecting anemia, the analysis allows you to identify other diseases, for example, polycythemia (a chronic disease in which the bone marrow produces an excessive amount of red blood cells) of various origins.Also, this study is used when it is necessary to assess the need for blood transfusion, to calculate the required volume of transfusion.

No special preparation is required for the hematocrit test. It is necessary to follow the standard rules for conducting a general blood test:

  • Blood is taken early in the morning.
  • Do not eat 6-10 hours before the test.
  • Avoid alcohol 2-3 days before the procedure.

Patients who smoke are advised to refrain from smoking for at least 2-3 hours prior to blood sampling.If these recommendations are not followed, the analysis may give unreliable results. This is due to the fact that the composition of the blood is subject to strong fluctuations depending on the action of various environmental factors.

Blood test for hematocrit

Manipulation is performed in the morning, blood is taken from a vein or from a finger. In the Medart clinic, the most modern equipment is used for the analysis, therefore, most often the sampling is performed from a vein.

To obtain the material, special vacuum containers (vacutainers) are used.This is a modern replacement for the syringe, which provides a number of benefits for the patient:

  • Virtually painless procedure.
  • Minimum time to obtain the correct amount of blood.
  • Accurate calculation of reagent and blood quantities.
  • Minimum time to conduct research and issue results to the patient.

Modern technologies allow manipulation as quickly as possible, without health consequences.

Standards

The normal level of hematocrit depends on the age, sex of a person.For a mature woman, it is 37-50%, for a man 34-45%. For newborns, this figure can be higher and ranges from 35 to 65%. In the process of growing up, the hematocrit decreases, reaching minimum levels in the elderly. This is the result of a decrease in the activity of the bone marrow and a decrease in the production of blood cell elements.

A decrease in the normal hematocrit in women is associated with regular blood loss during menstruation. High values ​​in children are a manifestation of active processes of development of the red bone marrow and other hematopoietic organs.

It is important to take into account that after massive blood loss, blood transfusions, the determination of the hematocrit level will give a result with a large error. For a reliable assessment of this indicator in such cases, it is necessary to wait a certain time.

It may take up to 3 months for the full physiological restoration of the level of red blood cells to normal values. This period is the life cycle of erythrocytes, during which the cellular composition of the blood is renewed.

Hematocrit increased

An increase in the level of erythrocytes revealed in the analysis for hematocrit may indicate various pathological conditions.The most common:

  • Primary erythrocytosis. It occurs as a result of overactive production of erythrocytes, including immature forms. May indicate the development of tumors in the bone marrow.
  • Secondary erythrocytosis. It develops as a consequence of pathologies of the respiratory and cardiovascular systems (heart defects, respiratory failure).
  • Decrease in plasma volume. May indicate the development of peritonitis, leukemia, kidney disease. Often occurs with extensive burns, when blood plasma flows through the damaged dermis.
  • Dehydration. It is observed in uncompensated diabetes mellitus, can result from diarrhea, vomiting, excessive sweating and lack of fluid in the diet.

Erythrocytosis can develop in heavy smokers, especially if smoking has led to secondary lesions of the respiratory system and heart. In this case, the body turns on the mechanisms of compensation for insufficient oxygenation due to a significant increase in the number of red cells.

An increase in hematocrit is not always a consequence of disease.An increase in the number of red blood cells is considered normal for mountain residents, professional climbers. With a sufficiently long stay in high altitude conditions, the body compensates for the lack of oxygen and atmospheric pressure by increasing the production of red blood cells.

Erythrocytosis is often asymptomatic, detected by chance, when taking a blood test for other reasons. Only with a significant increase in hematocrit are observed:

  • Pain in joints, muscles.
  • Shortness of breath.
  • High blood pressure.
  • Tinnitus and dizziness.
  • Excessive sweating, sleep disturbances.

These symptoms are not specific, therefore, if such ailments appear, you should consult a doctor for further diagnosis.

To restore the physiological level of hematocrit, it is required to find out the reason that led to the increase in the number of blood corpuscles and eliminate it. For example, if erythrocytosis was caused by dehydration (lack of water in the body – dehydration), it is enough to restore the normal amount of fluid to normalize this indicator.

There is no need to self-medicate, only a specialist can determine the exact cause of the hematocrit growth and prescribe the correct diagnosis and treatment. Therefore, for any changes in the blood test, you need to consult with a specialist and strictly follow the recommendations received.

Hematocrit lowered

The main reason for the decrease in hematocrit is anemia. There are many reasons for the development of these diseases, the most common are:

  • Disorders in the process of erythrocyte maturation.Associated with a lack of iron and B vitamins in food or their insufficient absorption from the digestive system. Less commonly, it occurs with the development of malignant tumors, whose cells compete with healthy ones and intensively absorb vitamins and minerals.
  • Abundant blood loss as a result of trauma or surgical procedures. Loss of blood does not always have to be immediate, the cause may be a small but regular bleeding from hemorrhoids or heavy periods.
  • Enhanced destruction of red blood cells. Occurs in case of poisoning with chemicals and organic poisons, after snake bites. Less commonly, it can occur when the liver and spleen are impaired. They are accompanied by severe jaundice, enlarged liver, intoxication, and other symptoms of massive destruction of red blood cells.

Not only anemia can lead to a decrease in hematocrit. Excessive accumulation of water in the body with impaired kidney function is often the cause of this condition.Severe infectious diseases can contribute to a decrease in the number of formed elements.

The main manifestations of a reduced hematocrit include:

  • Pale skin, hair loss and brittle nails.
  • Appearance of desire to use land, chalk.
  • General fatigue, drowsiness.
  • Bluish tint of the sclera.
  • Increased heart rate.

If one or more of these symptoms appear, you should consult a doctor to determine the cause of the decrease in the hematocrit level.Often, to restore this indicator, it is enough to normalize nutrition, saturating the body with vitamins, proteins, and a number of other active substances that are indispensable for the synthesis of red blood cells.

It is important to consider that a decrease in hematocrit may be a normal variant. Often this figure decreases in 2-3 trimesters of pregnancy. The reason for the phenomenon is a rapid increase in the proportion of plasma in the blood of a pregnant woman, which the body does not have time to compensate by activating the red bone marrow.In most cases, this condition does not require intervention, the blood composition is restored on its own.

If the reason for the decrease in hematocrit is a disease, you need to be examined by a specialized specialist to clarify the diagnosis and select the appropriate treatment regimen. In the case when the cause was blood loss, the tactics of treatment will depend on the amount of blood lost. With blood loss of up to 0.5 liters, sufficient nutrition and bed rest are sufficient. When bleeding large volumes, blood transfusion may be required to compensate for the lost red blood cells.Often it is combined with oxygen therapy – the supply of a gas mixture with an increased oxygen content to the patient for breathing.

Hematocrit

Hematocrit – the ratio of the volume of erythrocytes to the volume of the liquid part of the blood.

Determination of hematocrit is an integral part of the general blood test and is not performed separately.

Synonyms Russian

Hematocrit value.

English synonyms

Ht, Hct, Hematocrit, Crit, Haematocrit, PCV, Packed Cell Volume.

Units

% (percent).

What kind of biomaterial can be used for research?

Venous or capillary blood.

General information about the study

Hematocrit determines the volume of blood that red blood cells occupy in the bloodstream. This indicator is expressed as a percentage. For example, a hematocrit of 45% means that 100 milliliters of blood contains 45 milliliters of red blood cells.

An increase in hematocrit occurs if the number of erythrocytes increases or the volume of the liquid part of the blood decreases, which happens with excessive loss of fluid in the body (for example, with diarrhea). A decrease in this indicator is observed, on the contrary, with a decrease in the number of erythrocytes (for example, due to their loss, destruction or decrease in their formation) or with overhydration – when a person receives too much fluid (for example, with excessive administration of intravenous solutions).

Hematocrit reflects not only the number of red blood cells, but also their size. If the size of red blood cells decreases (as in iron deficiency anemia), the hematocrit will also decrease.

What is the research used for?

  • In the diagnosis of anemia and polycythemia and to assess the effectiveness of their treatment.
  • To determine the degree of dehydration.
  • As one of the criteria when deciding on the need for a blood transfusion.
  • To assess the effectiveness of blood transfusions.

When is the study scheduled?

This test is part of a routine general blood test, which is performed both routinely and for various diseases and pathological conditions, before surgical interventions.

In addition, it can be repeated and at regular intervals:

  • with dynamic observation and evaluation of the effectiveness of treatment of anemia and polycythemia,
  • after conditions causing dehydration,
  • for recurrent bleeding for a comprehensive assessment of their severity.

What do the results mean?

Reference values ​​

Age

Floor

Hematocrit,%

41-65

14 days – 1 month

33-55

1-2 months

28-42

2-4 months

32-44

4-6 months

31-41

6-9 months

32-40

9-12 months

33-41

1-3 years

32-40

3-6 years

33-41

6-9 years

34-43

9-12 years

35-45

12-15 years

male

35-45

female

34-44

15-18 years

male

37-48

female

34-44

18-45 years old

male

39-49

female

35-45

45-65 years

male

39-50

female

35-47

> 65 years

male

37-51

female

35-47

As a rule, the level of hematocrit corresponds to the number of red blood cells, but this is true only in cases where the size of red blood cells is normal.If the number of normal-sized red blood cells increases, then the hematocrit also increases. In cases of large or small red blood cells, this is not always the case. For example, with iron deficiency, red blood cells decrease and the hematocrit will be reduced, but the number of red blood cells in a blood unit may be normal and even slightly higher.

The level of hematocrit above 55% requires clarification of the cause and further diagnostic search.

Reasons for a decrease in hematocrit:

  • iron, B 12 – or folate deficiency anemia,
  • acute or chronic bleeding (during or immediately after bleeding, the level of hematocrit and hemoglobin will be increased),
  • disorders of hemoglobin synthesis (sickle cell anemia, thalassemia),
  • cirrhosis of the liver,
  • destruction of red blood cells as a result of hemolysis – destruction of red blood cells inside the body (it can occur for various reasons – due to a hereditary defect in red blood cells, as a result of the appearance of antibodies to its own red blood cells or toxic effects in malaria),
  • oncological diseases of the bone marrow or metastases of other tumors in the bone marrow, leading to a decrease in the synthesis of red blood cells,
  • Excessive hydration of the body – the introduction of large volumes of intravenous fluids.

Reasons for increased hematocrit:

  • dehydration (dehydration) of any origin – due to diarrhea, profuse vomiting, diabetes, after burns,
  • Polycythemia vera from excess production of red blood cells in the bone marrow,
  • chronic obstructive pulmonary disease,
  • chronic heart failure.

What can influence the result of ?

  1. The hematocrit level is normally reduced in pregnant women due to a physiological increase in the volume of the liquid part of the blood.
  2. In persons climbing to a great height, there is an increase in the number of erythrocytes and, accordingly, hematocrit, as their body adapts to a reduced oxygen concentration.
  3. In smokers, hematocrit may be increased due to oxygen starvation of tissues and increased production of red blood cells.
  4. In newborns, the level of hematocrit is increased, since they have quite a lot of large red blood cells in their blood.

Important Notes

  • Erythrocyte count, hemoglobin and hematocrit are to a large extent related to the degree of hydration of the body.If the volume of the liquid part of the blood decreases with excessive loss of fluid, these indicators will increase. However, the absolute number of erythrocytes and hemoglobin does not change.

Also recommended

Who orders the study?

General practitioner, internist, hematologist, nephrologist, surgeon.

90,000 The rate of a complete blood count during pregnancy. Hemoglobin, platelets, hematocrit, erythrocytes and leukocytes during pregnancy.Clinical blood test during pregnancy. Hematological changes during pregnancy.

Translation of materials from UpTodate.com
A normal pregnancy is characterized by significant changes in almost all organs and systems to adapt to the requirements of the fetoplacental complex, including changes in blood test values ​​during pregnancy.

Norms of blood analysis during pregnancy: a summary of article

  • Significant hematological changes during pregnancy are physiological anemia, neutrophilia, moderate thrombocytopenia, increased coagulation factors and decreased fibrinolysis.
  • By 6-12 weeks of gestation, the blood plasma volume increases by about 10-15%. The fastest rate of increase in blood plasma volume is observed in the period from 30 to 34 weeks of pregnancy, after which the volume of plasma changes slightly.
  • The number of red blood cells begins to increase at 8-10 weeks of pregnancy and by the end of pregnancy increases by 20-30% (250-450 ml) relative to the normal level for non-pregnant women by the end of pregnancy A significant increase in plasma volume relative to an increase in hemoglobin and red blood cell volume leads to a moderate a decrease in the level of hemoglobin (physiological anemia of pregnant women), which is observed in healthy pregnant women.
  • Pregnant women may have a slight decrease in platelet count compared to healthy non-pregnant women.
  • The number of neutrophils begins to rise in the second month of pregnancy and stabilizes in the second or third trimester, at which time the number of leukocytes. The absolute number of lymphocytes does not change.
  • The level of some blood clotting factors changes during pregnancy.

This article describes the hematological changes that occur during pregnancy, the most important of which are:

  • Increase in blood plasma volume and decrease in hematocrit
  • Physiological anemia, low hemoglobin
  • Increased leukocytes during pregnancy
  • Neutrophilia
  • Moderate thrombocytopenia
  • Increased procoagulant factors
  • Reduction of fibrinolysis

Analyzes referred to in Article

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Blood plasma volume

By 6-12 weeks of gestation, the blood plasma volume increases by about 10-15%.The fastest rate of increase in blood plasma volume is observed in the period from 30 to 34 weeks of pregnancy, after which the volume of plasma changes slightly. On average, the volume of blood plasma increases by 1100-1600 ml per trimester, and as a result, the volume of plasma during pregnancy increases to 4700-5200 ml, which is 30 to 50% higher than the plasma volume in non-pregnant women.

During pregnancy, plasma renin activity tends to increase, while the level of atrial natriuretic peptide decreases slightly.This suggests that the increase in plasma volume is caused by a failure of the vascular system, which leads to systemic vasodilation (vasodilation throughout the body) and an increase in vascular capacity. Since it is the volume of blood plasma that initially increases, its effect on the renal and atrial receptors leads to opposite effects on the hormonal background (a decrease in plasma renin activity and an increase in natriuretic peptide). This hypothesis is also supported by the observation that increasing sodium intake does not affect further increases in plasma volume.

After childbirth, plasma volume immediately decreases, but rises again after 2-5 days, possibly due to an increase in aldosterone secretion that occurs at this time. Then the plasma volume gradually decreases again: 3 weeks after delivery, it is still increased by 10-15% relative to the normal level for non-pregnant women, but usually returns to normal after 6 weeks after delivery.

Erythrocytes during pregnancy, ESR during pregnancy

The number of red blood cells begins to increase at 8-10 weeks of gestation and by the end of pregnancy increases by 20-30% (250-450 ml) relative to the normal level for non-pregnant women, especially in women who took iron supplements during pregnancy.Among pregnant women who did not take iron supplements, the number of red blood cells can increase by only 15-20%. The life span of red blood cells decreases slightly during normal pregnancy.

The level of erythropoietin in normal pregnancy increases by 50% and its change depends on the presence of complications of pregnancy. The increase in plasma erythropoietin leads to an increase in the number of red blood cells, which partly provide the high metabolic oxygen requirements during pregnancy.

In women who do not take iron supplements, the average volume of red blood cells decreases during pregnancy and in the third trimester averages 80-84 fl. However, in healthy pregnant women and in pregnant women with moderate iron deficiency, the average volume of red blood cells increases by about 4 fl.

ESR increases during pregnancy, which has no diagnostic value.

Anemia during pregnancy, hemoglobin during pregnancy, hematocrit during pregnancy, low hemoglobin during pregnancy

Decrease in hemoglobin during pregnancy

A significant increase in plasma volume relative to an increase in the amount of hemoglobin and the volume of red blood cells leads to a moderate decrease in hemoglobin levels (physiological anemia or low hemoglobin in pregnant women), which is observed in healthy pregnant women.The largest difference between the rate of increase in blood plasma volume and the number of red blood cells in the maternal bloodstream is formed during the end of the second, early third trimester (a decrease in hemoglobin usually occurs at 28-36 weeks of pregnancy). The concentration of hemoglobin increases due to the cessation of the increase in plasma volume and the continuation of the increase in the amount of hemoglobin. On the contrary, the absence of physiological anemia is a risk factor for stillbirth.

Anemia during pregnancy

Establishing a clear definition of anemia in pregnant women is difficult becauseBecause it consists of pregnancy-related changes in blood plasma volume and red blood cell count, physiological differences in hemoglobin concentration between women and men, and the frequency of use of iron supplements during pregnancy.

  • The Centers for Disease Prevention and Control has defined anemia as less than 110 g / L (less than 33% hematocrit) in the first and third trimesters and less than 105 g / L (less than 32% hematocrit) in the second trimester.
  • WHO defined anemia in pregnant women as a decrease in hemoglobin less than 110 g / l (11 g / dl) or a hematocrit less than 6.83 mmol / l or 33%.Severe anemia of pregnancy is determined by a hemoglobin level of less than 70 g / l and requires medical treatment. Very severe anemia is defined as a hemoglobin level of less than 40 g / L and requires urgent medical attention due to the risk of congestive heart failure.

Women with hemoglobin values ​​below these levels are considered anemic and should undergo routine tests (CBC with peripheral smear, reticulocyte count, serum iron, ferritin, transferrin).If no abnormalities were found during examination, then hemoglobin reduced to a level of 100 g / l can be considered physiological anemia with a wide variety of factors affecting the normal hemoglobin level in a particular person.

Chronic severe anemia is most common in women in developing countries. A decrease in maternal hemoglobin below 60 g / l leads to a decrease in the volume of amniotic fluid, vasodilation of the cerebral vessels of the fetus and a change in the heart rate of the fetus.There is also an increased risk of premature birth, miscarriage, low birth weight and stillbirth. In addition, severe anemia (hemoglobin less than 70 g / L) increases the risk of maternal death. There is no evidence that anemia increases the risk of fetal congenital anomalies.

Severe chronic anemia is usually associated with insufficient iron stores (due to insufficient dietary intake or intestinal helminthic invasions), folate deficiency (due to insufficient intake and chronic hemolytic conditions such as malaria).Thus, it is possible to prevent chronic anemia and improve pregnancy outcomes with dietary supplements and infection control measures.

Blood and red blood cell transfusion (where safe blood transfusion is available) is a reasonable aggressive treatment for severe anemia, especially if there are signs of fetal hypoxia.

Signs of physiological anemia of pregnancy disappear 6 weeks after delivery, when the plasma volume returns to normal.

Iron requirement

In singleton pregnancies, the iron requirement is 1000 mg per pregnancy: approximately 300 mg for the fetus and placenta and approximately 500 mg, if any, to increase the amount of hemoglobin. 200 mg is lost through the intestines, urine and skin. Since most women do not have an adequate supply of iron to meet their needs during pregnancy, iron is usually prescribed as part of a multivitamin or as a separate supplement. In general, women taking iron supplements have a 1 g / dl higher hemoglobin concentration than women who are not taking iron.

Folate requirement

The daily folate requirement for non-pregnant women is 50-100 mcg. An increase in the number of red blood cells during pregnancy leads to an increase in the need for folic acid, which is ensured by an increase in the dose of folic acid to 400-800 mcg per day to prevent neural tube defects in the fetus.

Platelets during pregnancy

In most cases, platelet count during uncomplicated pregnancy remains within the normal range for non-pregnant women, but it is also possible for pregnant women to have a decrease in platelet count compared to healthy non-pregnant women.The platelet count begins to rise immediately after childbirth and continues to increase for 3-4 weeks until it returns to normal values.

Thrombocytopenia during pregnancy

The most important change in platelet physiology during pregnancy in obstetrics is thrombocytopenia, which may be associated with pregnancy complications (severe preeclampsia, HELLP syndrome), drug disorders (immune thrombocytopenia), or gestational thrombocytopenia.

Gestational or accidental thrombocytopenia is asymptomatic in the third trimester of pregnancy in patients without prior thrombocytopenia. It is not associated with maternal, fetal, or neonatal complications and resolves spontaneously after delivery.

Leukocytes during pregnancy

During pregnancy, leukocytosis is observed, mainly associated with an increase in circulating neutrophils. The number of neutrophils begins to grow in the second month of pregnancy and stabilizes in the second or third trimesters, at which time the number of leukocytes increases from 9 * 10 ^ 9 / l to 15 * 10 ^ 9 / l.The white blood cell count is reduced to the reference interval for non-pregnant women by the sixth day after delivery.

In the peripheral blood of pregnant women, there may be a small amount of myelocytes and metamyelocytes. According to some studies, there is an increase in the number of young forms of neutrophils during pregnancy. Lobes’ bodies (blue staining of cytoplasmic inclusions in granulocytes) are considered the norm in pregnant women.

In healthy women with uncomplicated pregnancy, there are no changes in the absolute number of lymphocytes and there are no significant changes in the relative number of T- and B-lymphocytes.The number of monocytes usually does not change, the number of basophils may decrease slightly, and the number of eosinophils may slightly increase.

Blood clotting factors and inhibitors

During normal pregnancy, the following changes in blood clotting factor levels occur, leading to physiological hypercoagulability:

  • Due to hormonal changes during pregnancy, the activity of total protein S antigen, free protein S antigen and protein S decreases.
  • Resistance to activated protein C increases in the second and third trimesters.These changes were identified in the first generation tests using pure blood plasma (i.e., not devoid of factor V), but this test is rarely used clinically and has only historical interest.
  • Fibrinogen and factors II, VII, VIII, X, XII and XIII are increased by 20-200%.
  • The von Willebrand factor rises.
  • Increased activity of fibrinolysis inhibitors, TAF1, PAI-1 and PAI-2. The level of PAI-1 also increases markedly.
  • Levels of antithrombin III, protein C, factor V and factor IX most often remain unchanged or slightly increase.

The end result of these changes is an increase in the tendency to thrombosis, an increase in the likelihood of venous thrombosis during pregnancy and, especially, in the postpartum period. Along with the reduction of the myometrium and the increase in the level of decidual tissue factor, hypercoagulation protects the pregnant woman from excessive bleeding during childbirth and placental separation.

APTT remains normal during pregnancy, but may decrease slightly. Prothrombin time may be shortened. The bleeding time does not change.

The timing of normalization of blood clotting activity in the postpartum period may vary depending on factors, but everything should return to normal within 6-8 weeks after delivery. The hemostasiogram does not need to be assessed earlier than 3 months after childbirth and after the completion of lactation to exclude the influence of pregnancy factors.

The influence of factors of acquired or hereditary thrombophilia on pregnancy is an area of ​​research.

Postpartum

Hematological changes associated with pregnancy return to normal levels 6-8 weeks after delivery. The rate and nature of normalization of changes associated with pregnancy, specific hematological parameters are described above in the section dedicated to each parameter.

Hematological complications during pregnancy

  • Iron deficiency anemia.
  • Thrombocytopenia.
  • Neonatal alloimmune thrombocytopenia.
  • Acquired hemophilia A.
  • Venous thrombosis.
  • Rh and non-Rh alloimmunization. For diagnosis, an analysis is carried out for Rh antibodies and antigroup antibodies.
  • The manifestation of a previously unrecognized coagulation disorder, such as von Willebrand disease, most often manifests itself in women during pregnancy and childbirth.For screening for von Willebrand disease, an analysis is performed to assess platelet aggregation with ristocetin.
  • Aplastic anemia.

90,000 Hematocrit is below normal – what does it mean, how to determine the indicator and what to do next?

A blood test helps to assess not only the functioning of the organs of the hematopoietic system, but also the state of the body as a whole. Among the parameters taken into account in the analysis, the leading position is occupied by the concentration of erythrocytes – hematocrit, as doctors call it.

What is the hematocrit in the blood test?

Patients, receiving the test results on their hands, seeing the hematocrit indicator, what kind of parameter it is and what it is responsible for, do not know. This term is usually used to denote the ratio of the volumetric amount of formed elements to a unit volume of whole blood. The indicator is expressed as a percentage, less often as a decimal fraction with a two-digit value after the decimal point. Often, experts refer to it as the hematocrit indicator. To calculate the hematocrit, the number of erythrocytes is compared with the plasma volume, then multiplied by 0.01 (for conversion to percent).

What is hematocrit responsible for?

From the above it follows that hematocrit is a quantitative indicator. The hematocrit number is a reflection of the cellular composition of the blood circulating in the human body. It does not depend on factors affecting the synthesis of intracellular hemoglobin. At the same time, the value is actively used by doctors with suspicion of latent diseases, anemia. The analysis is often prescribed after surgery and during pregnancy. This is done to eliminate the risk of losing a large volume of blood.

The value of hematocrit is a primary indicator in the diagnosis of pathologies. Deviation from existing standards becomes an indication for further comprehensive examination of the patient. To find out why the hematocrit is below normal, what this means, it is required to undergo more than one examination. Among the indications for the analysis are:

  • varicose veins;
  • autoimmune diseases;
  • liver pathology;
  • high risk of bleeding.

Hematocrit – norm

Studies conducted by doctors have shown that the hematocrit value changes with the age of the patient. In addition, due to the peculiarities of physiology, the values ​​are lower in girls than in men. Given this feature, when decoding the analysis for hematocrit, the norm in women is set lower. Among the determining factors during the assessment of the result is the age of the patient. The hematocrit in the blood changes as follows:

  1. Children:
  • newborns – 35–65;
  • 90,015 up to 1 year – 32–40;

  • 1-11 years old – 32-41;
  • 90,015 girls 12-17 years old – 35-45;

    90,015 boys 12-17 – 34-44.

  1. Adults:
  • women 18–45 years old – 39–50;
  • 90,015 men 18–45 years old – 34–45;

    90,015 women over 45 – 40-50;

    90,015 women after 45 years – 35–46.

Hematocrit is lowered – what does it mean?

Deviation of values ​​from existing standards is an indication for further examination of the patient. To find out why the hematocrit is lowered, what does this mean in a woman, hardware research methods are prescribed:

  • Ultrasound of the pelvic organs;
  • ultrasound of the liver;
  • examination of the organs of the gastrointestinal tract.

To find out why the hematocrit is below the established norm, what this means, doctors take into account the time of the analysis. During menstruation and a few days after its end, the hematocrit level in girls decreases. The hematocrit is below normal and during pregnancy, which a woman often does not know about at a short time.

Hematocrit lowered – causes

When the hematocrit is lowered, what is this violation and what is it connected with – only a specialist can determine. The analysis is deciphered exclusively by doctors who have information about the general condition of the patient’s body, his diseases and chronic pathologies.Among the disorders and conditions accompanied by a decrease in hematocrit:

  1. Aplastic anemia – provoked by congenital and hereditary diseases, toxic damage to the bone marrow.
  2. Hemolysis – resolution of blood cells in case of congenital anomalies of erythrocytes, a decrease in their elasticity, diseases of the spleen.
  3. Hyperhydration – the introduction of a large amount of fluid into the body during infusion.
  4. Increase in the volume of proteins and salts in plasma, which leads to a relative decrease in the concentration of blood cells.
  5. Pregnancy.

Low hematocrit – symptoms

The fact that the hematocrit is low can be suspected by a number of characteristic signs. Most of them have no specificity, so patients often do not attach importance to them. Among the main symptoms of a decrease in hematocrit in the body:

  • general malaise – a decrease in the concentration of red blood cells leads to a decrease in the volume of oxygen delivered by blood cells to organs and tissues;
  • permanent fatigue;
  • the appearance of a feeling of lack of air;
  • pallor of the skin;
  • tachycardia;
  • hair loss;
  • frequent headaches.

Why is low hematocrit dangerous?

Reduced hematocrit in the blood indicates insufficient production of red blood cells – erythrocytes. These shaped elements are responsible for the delivery of oxygen and some nutrients to the organs and tissues of the body. A decrease in their concentration is fraught with the development of chronic hypoxia – constant oxygen starvation. This phenomenon negatively affects the functioning of the brain. Memory impairment, decreased ability to concentrate, and mental activity are directly related to cerebral hypoxia.

Hematocrit below normal (which means – indicated above) is the cause of the development of anemia. As a result, there is a violation of the processes of hematopoiesis. Such patients are more prone to colds and infectious diseases, constantly experience weakness and fatigue. Other negative consequences of low hematocrit include:

  • heart disease;
  • violation of the liver;
  • deterioration of kidney function (toxins are poorly excreted from the body, intoxication is possible).

How to increase the hematocrit?

Before increasing the hematocrit in the blood, starting therapy for the deviation, doctors carry out a comprehensive diagnosis. Establishing the direct cause of the violation is the main task of specialists. Often, the exclusion of the factor provoking a decrease in hematocrit leads to the normalization of the indicator. Among the main areas of treatment for this disorder:

  • therapy with iron-containing drugs – Sorbifer, Maltofer, Ferritab;
  • enrichment of the diet with foods containing iron: meat, eggs, nuts, liver, pomegranate;
  • reduction of physical activity on the body;
  • Frequent walks in the fresh air.

Hematocrit lowered during pregnancy

Hematocrit always decreases during pregnancy. This phenomenon is physiological in nature. As gestation develops, plasma volume increases, resulting in fewer erythrocytes per unit volume of blood. The drop in the indicator begins from about the 4th week of pregnancy. At the same time, the maximum minimum is recorded at 32–34 weeks – 31–35%. In this way, the body prepares for possible blood loss during childbirth. A decrease in the indicator below 30% increases the risk of developing fetal hypoxia.With a hematocrit of 14-25%, the pregnant woman is hospitalized and constantly monitored.

Universal Veterinary Clinic, CBC

CBC is a test profile used to describe the quantity and quality of cellular elements in blood and plasma. Most often, in daily practice, this is the first step to assess the condition of the animal. The body of our patients is exposed to various environmental factors and gives a specific assessment of stimuli.When the indicators of clinical analysis change, we can talk about the possible cause of the disease.

Basic indicators of the clinical blood test:

1) Hemoglobin (HGB) is a pigment contained in erythrocytes, the function of which is to transport oxygen and carbon dioxide through the vessels. Its determination in the blood is not only of diagnostic value, it is also important from the point of view of predicting the disease, since pathological conditions leading to a decrease in the content of this indicator lead to oxygen starvation of tissues.

2) Hematocrit (Ht, HCT) – the volume of red blood cells in the blood. An increase in this indicator may indicate erythrocytosis (an increase in the number of red blood cells), dehydration or a decrease in the volume of circulating plasma.
A decrease in hematocrit indicates severe anemia. Low hematocrit is also typical for chronic inflammatory processes, trauma, starvation, chronic kidney disease, and cancer.

3) Erythrocytes ( RBC ) – red blood cells containing hemoglobin.The main functions are to carry oxygen from the lungs to the tissues of the body and to carry carbon dioxide from the organs to the lungs.

4) Leukocytes ( WBC ) – white blood cells with a nucleus. Their main function is to protect the body from various pathological agents, as well as internal pathological processes that are accompanied by inflammation.

Leukocytes are divided into two fractions: granulocytes (neutrophils, basophils, eosinophils) and agranulocytes (lymphocytes and monocytes).Their ratio in the blood plays an important diagnostic role, therefore their number is described in leukocyte formula .

5) Platelets ( PLT ) – elements responsible for the integrity of blood vessels play an essential role in the regeneration and healing of damaged tissues.

A 12-hour fasting diet is recommended for taking a general clinical blood test. Blood is taken from peripheral veins in a volume of about 2 ml (depending on the tube).It is carefully mixed and sent to the laboratory at a temperature of + 2 … + 8 degrees Celsius. In our center, blood immediately goes to the laboratory, where it is analyzed within 5 minutes on the ProCyte Dx clinical analyzer (IDEXX), which is currently the “gold standard” of automatic clinical analyzers.

Decoding of the general clinical blood test is carried out only by a veterinarian.

We wish you and your pets health.

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Diagnostic Center MEDLIFE-BIO

Complete blood count – a set of tests aimed at determining the number of various blood cells (erythrocytes, leukocytes, platelets), their characteristics and ratio.A complete blood count is the most commonly prescribed type of laboratory research. This test is used both for a general assessment of health status during routine examinations, before surgical interventions, as well as for diagnostics, determining a possible cause, and evaluating the effectiveness of treatment of anemias (anemia), infections and inflammatory processes, blood clotting disorders, leukemias (leukemias), allergies …

The following symptoms may become a reason for going to a doctor and prescribing a complete blood count:
– weakness, fatigue, shortness of breath with light or moderate exertion, palpitations, headache, tinnitus, sleep disturbances, appetite, sexual desire – signs of anemia;
– pain in the affected organ, redness and swelling of the skin, fever, chills, headache, joint aches, decreased appetite – signs of infectious and inflammatory processes;
– blockage of blood vessels and, conversely, increased bleeding – signs of a violation of blood coagulation;
– anemia, increased bleeding, and infectious complications – can occur with leukemia;
– suffocation attacks, runny nose, eye inflammation, redness and swelling of the skin, indigestion are signs of allergies.

Given the high value of a complete blood count for the diagnosis of a wide range of diseases, its results must meet the high reliability requirements of . It should be noted that blood tests performed by “manual” methods have large errors and often cause justified criticism from both doctors and patients. It is from the point of view of the reliability of the results obtained that automated hematological analyzers have a number of advantages over “manual” research.
The main ones are:
– analysis of a large number of cells: more than 10 thousand, compared with 100-200 cells with a visual method of counting,
– standardization of each stage of analysis,
– minimization of the “human factor”.

Most of the hematological analyzers functioning in the laboratories of Ukraine determine up to 18 parameters of the general blood test, and are not capable of performing a complete analysis of the leukocyte formula. In the diagnostic center “Global-Diagnostic”, a general blood test is performed using a complex analytical system Sysmex XS-1000i (Japan) , which determines 24 parameters of a general blood test, and allows you to obtain a number of additional cell characteristics that cannot be assessed by visual analysis blood smear.The Sysmex XS-1000i analyzer not only performs a detailed blood test with differentiation of leukocytes into 5 subtypes, but also plots the distribution of leukocytes, erythrocytes and platelets by size. The analysis of these graphs provides additional diagnostically valuable information.
A unique feature of this analyzer is the ability to detect immature leukocytes, blasts, atypical and pathological lymphocytes. The presence of even 1% of such cells in a sample can be a sign of serious pathology, while when only 100 cells are analyzed in a smear, they can be “skipped”.
However, the role of the laboratory assistant in performing this study is also very important. The analyzer “issues” a special message about any deviations from the norm, as well as finds requiring additional research, and these samples are then analyzed “visually” by a qualified specialist to confirm and clarify pathological findings.
For analysis, both venous and capillary blood can be used.

Clinical and diagnostic value of indicators of the general blood test
Hematocrit (HCT) – the percentage of blood cells (formed elements) to its liquid part; is used in a comprehensive assessment of anemias and conditions in which the number of formed elements, on the contrary, increases (erythrocytosis, leukemia), helps to decide on the need for blood transfusion and to evaluate the results of this procedure.
Hemoglobin (HGB) is the main component of red blood cells, with which they transport oxygen from the lungs to tissues and organs, and carbon dioxide from tissues and organs to the lungs. The concentration of hemoglobin in the blood is an important indicator for assessing the severity of anemia or erythrocytosis and for monitoring the effectiveness of therapy for these conditions.
Red blood cells (RBC) – cells containing hemoglobin and transporting oxygen and carbon dioxide in human blood. Determination of the number of red blood cells is necessary for the diagnosis of anemia or erythrocytosis and differentiation between different types of anemia.
Erythrocyte indices: provide information on the size of red blood cells and their hemoglobin content.
average erythrocyte volume (MCV) – characterizes the size of these cells; it is necessary to determine the cause of anemia. So, for example, with a deficiency of vitamin B12, the size of red blood cells increases, with a deficiency of iron, it decreases.
mean erythrocyte hemoglobin (MCH) and mean erythrocyte hemoglobin concentration (MCHC) complement each other and are used instead of the obsolete and less informative color indicator.These indices help determine the cause of the anemia. So, for example, with a deficiency of vitamin B12 in enlarged erythrocytes, the content and concentration of hemoglobin are increased, and with a deficiency of iron, they are reduced.
the width of distribution of erythrocytes by volume (RDW) – an indicator that determines the degree of difference in size of the patient’s erythrocytes. It is important in the early diagnosis of anemia, since it often changes earlier than the size of red blood cells. Allows you to evaluate the effectiveness of the treatment of anemia.
Leukocytes (WBC) – a group of cells whose main task is to detect foreign agents (bacteria, viruses) in the body and destroy them.Determination of the number of leukocytes is necessary for the diagnosis of infections, damage to body tissues, malignant tumors, bone marrow diseases.
Leukocyte formula – relative (%) and absolute number of leukocytes of different types: neutrophils, lymphocytes, monocytes, eosinophils, basophils. If counting the total number of leukocytes allows you to find out the total number of these cells, then the leukocyte formula is the number of cells of each type separately. This information is of great importance for the diagnosis of diseases, since each type of white blood cell has a specific function.
Neutrophils – the most numerous of the leukocytes – are the first to fight against pathogens of bacterial and fungal infections and are the first to appear at the site of tissue damage (organ infarctions, burns, trauma, surgery). An increase in the number of neutrophils is one of the main laboratory signs of any suppurative process. A decrease in the number of neutrophils may indicate primary damage to the bone marrow or its depletion, and is an unfavorable prognostic sign, as it increases the risk of infection.
With many severe infections, septic and purulent processes, malignant tumors, diseases of the bone marrow, the leukocyte formula changes due to an increase in the percentage of young forms of neutrophils: stab, metamyelocytes, myelocytes and promyelocytes. Such a change in the leukocyte formula is called a left shift. The Sysmex XS-1000i analyzer automatically detects and counts even the smallest (less than 0.5%) amount of these immature forms of neutrophils.
Eosinophils – protects the body from parasites, and also actively participate in allergic reactions. Therefore, the presence of parasites in the body or such allergic diseases as rhinitis, conjunctivitis, asthma, eczema are accompanied by an increase in the number of eosinophils in the blood.
Basophils – normally participate in the regulation of the permeability of the vascular wall, and in pathology – in the development of immediate allergic reactions, inflammatory processes.Therefore, if you are allergic to food or medicinal drugs, the number of these cells in the blood may increase. Also, an increase in the number of basophils may indicate bone marrow disease.
Lymphocytes are the main cells of the immune system, their main function is to recognize molecules (antigens) that are dangerous to the body and respond specifically to them. As a result of an adequate response to antigenic stimulation, an increase in the number of lymphocytes occurs; with an inadequate response, the number of lymphocytes may decrease.Lymphocytes are actively involved in the development of immunodeficiency states, infectious, allergic, oncological diseases, rejection of transplanted organs, as well as autoimmune processes. With these processes, the number of lymphocytes in the blood can change significantly.
Monocytes – cells involved in the body’s defense reactions. They are removed from the body by absorption (phagocytosis) of dying cells and bacteria. An increase in the number of monocytes in the blood can be a consequence of bone marrow diseases or antigenic irritation.
Platelets are cells that play an important role in blood clotting. If a person has a low platelet count, they are at increased risk of bleeding and bruising.
Platelet count (PLT) – often determines the likelihood of thrombosis or bleeding. The reasons for the change in the number of platelets can be bone marrow diseases, malignant tumors, infections, inflammatory diseases.
Thrombocritis (PCT ) is the proportion of whole blood volume occupied by platelets.
Platelet indices
Average platelet volume (MPV) and percentage of large platelets (P-LCR) characterize the size of these cells, indicate their activity and rate of formation in the bone marrow.
Platelet Volume Distribution Width (PDW) is a measure of the extent to which a patient’s platelets differ in size, which can help determine the cause of a change in the number of these cells.

Erythrocyte sedimentation rate (ESR)
This technique measures the rate of erythrocyte sedimentation to the bottom of the capillary under the action of gravity.Bonding of erythrocytes leads to the formation of clusters (aggregates) of these cells, the weight of which is much higher than a single erythrocyte, and which therefore settle faster.
The ESR value depends on two main components. First? the presence and level of proteins-globulins in plasma, the amount of which increases during inflammatory processes due to infection, as well as in case of damage to body tissues (heart attack, burns, etc.). These proteins are fixed on the surface of red blood cells and stimulate their adhesion to each other.The second component is blood viscosity, which, first of all, depends on the number of erythrocytes themselves (a smaller number of erythrocytes is higher than ESR, and vice versa).
Unfortunately, very often the results of ESR determination by the traditional method for our country (Panchenkova) do not correspond to the clinical picture. This is not surprising, since this method is not subject to quality control and cannot be standardized!
First of all, it is not possible to standardize the procedure for obtaining capillary blood.Anyone who has donated blood from a finger for analysis at least a couple of times will agree that in order to obtain a sufficient amount of blood, the laboratory assistant has to excessively compress the narrow puncture site. As a result of this, firstly, part of the erythrocytes can be destroyed, and secondly, a tissue fluid rich in globulin proteins enters the blood sample. Meanwhile, it is these two components that determine the ESR value.
In addition, a number of nonspecific factors affect the ESR value: the quality of the capillary, the correct dilution of blood with sodium citrate before the study, the quality of sodium citrate.
It should be noted that in developed countries for the “manual” determination of ESR, they use the Westergren method, which is recommended by the World Health Organization. The differences between the Westergren and Panchenkov methods are in the structure of the capillary. All methodological documents of the International Committee for Standardization in Hematology (ICSH) and the World Health Society strictly regulate that the inner diameter of the capillary must be at least 2.55 mm, but the inner diameter of the Panchenkov capillary is only 1 mm.If large accumulations of red blood cells are formed, then with such a narrow lumen, they can block their own sedimentation. As a result, the erythrocyte sedimentation rate is artificially reduced.
International standards also state that the length of the graduated working surface of the capillary for determining the ESR must be at least 200 mm. The Panchenkov capillary has a working surface length of 100 mm, which sharply limits the level of maximum ESR values.
However, the Westergren method is not ideal , and also has a number of disadvantages that make it difficult to use it effectively, namely:
one.Duration of obtaining results: 60 minutes, while the rest of the indicators of the general blood test can be obtained in 60 seconds.
2. Despite the standardization, the variability of the ESR determination results remains at a high level – the difference can reach more than 15%.
3. When a laboratory technician is working with dozens of samples at the same time, it is very difficult Difficulty working with a series of samples. It takes about 30 seconds to load each sample into the ESR rack.If it is necessary to load 10 samples for ESR analysis, then from the setting of the first capillary to the last one takes on average 5 minutes, therefore, if we evaluate the last capillary in 60 minutes, then the first one in 65 minutes after setting. Moreover, if we take into account that the ESR between 60 and 66 minutes can change by 10 mm, then the results in the first capillary will be falsely overestimated.
4. Difficulty standardizing the temperature regime for performing ESR measurements. According to ICSH recommendations, ESR analysis should be carried out at a constant temperature with fluctuations of no more than 1 ° C.This requirement is due to the fact that a change in temperature by one degree Celsius leads to a change in ESR by 3%.
5. The classical Westergren method is practically not amenable to automation.
6. One of the main limitations of the Westergren method is the impossibility of including this method in the quality control system, which makes the results obtained using this method approximate and unreliable.

The presence of the above limitations of the classical method for determining ESR according to Westergren forced the research laboratories of leading manufacturers in the field of laboratory equipment to look for new methods for its determination that would satisfy all the methodological and clinical needs of modern laboratories.Developments in this area have resulted in fully automated analytical systems for measuring ESR of the Roller type by Alifax (Italy). The unique method for determining ESR, implemented in this device, allowed to solve all the problems inherent in the classical Westergren method, while the correlation with the reference method is 95–99%.
According to the methodology of the Westergren reference method, the result of erythrocyte sedimentation is assessed once 60 minutes after setting, i.e.That is, he assesses not the sedimentation rate, but the amount of erythrocyte sedimentation in 1 hour. The principle of operation of the Roller analyzer is based on measuring the kinetics of erythrocyte aggregation, which is achieved by multiple evaluation (1000 measurements) of the optical density of the sample under study in a special capillary for 20 seconds. This means that these analyzers really measure the speed of the process. In addition, the analyzers offered by Alifax evaluate the most specific phase of the erythrocyte sedimentation process, namely the aggregation phase.
The introduction into practice of automatic ESR analyzers made it possible to eliminate the limitations associated with the classical Westergren method, namely:
1. The duration of one ESR study is 20 seconds, which allows you to receive a complete complete blood count within 1 minute, including the results of counting blood cells, differentiation of the formula and ESR.
2. The Roller analyzer uses whole blood with EDTA as a biological material for studying ESR, which makes it possible to determine ESR and perform automatic hematological analysis from one tube.This eliminates the need to collect blood separately with sodium citrate, and this greatly simplifies the blood collection process, reduces costs (there is no need to use special vacuum tubes with sodium citrate) and eliminates an additional source of errors associated with blood dilution and the quality of sodium citrate (in the case of if special tubes are not used).
3. Alifax analyzers are not sensitive to the influence of such sample properties as high / low hematocrit MCV, as well as to fluctuations in ambient temperature.
One of the main advantages of ESR analyzers offered by Alifax is the ability to include ESR studies in the quality control system. Special three-level control materials have been developed that allow quality control of ESR determination on the analyzer and Roller in accordance with all standards.
To date, a sufficient amount of material has been accumulated in order to draw a conclusion about the good diagnostic efficiency of using the ESR results obtained using the Roller analyzer.Some publications indicate a greater sensitivity of the ESR measurement result, in comparison with the classical Westergren method, for assessing active inflammation in cancer patients, as well as in patients with autoimmune diseases and infections.

ESR clinical application range: old and new possibilities.
A well-known fact is the dependence of ESR values ​​on age, sex, race (Table 8).

Table 8. ESR reference values ​​for different clinical groups.

Clinical group ESR values, mm / hour
Pregnant [16]
First trimester 4 – 57
Second trimester 7 – 47
Third trimester 13 – 70
Adults under 50 [17]
Men
Women
Adults> 50 years [17]
Men
Men

The use of new standardized methods for determining ESR will expand the range of clinical application of the results of this test.The above reference values ​​developed for the Westergren method are applicable to the interpretation of ESR results obtained with the Roller analyzer.
The use of ESR for screening in the general population of people without clinical symptoms of the disease is not currently recommended. At the same time, this test can be useful in conjunction with the results of physical examination and history taking to identify pathological conditions in patients with clinical manifestations.It was demonstrated that in 68% of cases, the obtained high ESR values ​​confirmed the doctor’s clinical hypothesis, previously formed on the basis of anamnestic data and examination data. According to the recommendations of some authors, the ESR indicator can be used as the so-called “pain index” in the group of hospitalized patients. For example, the percentage of detection of new diseases among patients with an ESR level of up to 20 mm / h was 7%, and with an ESR level of more than 50 mm / h, this indicator increased to 66%.
Particular attention should be paid to the interpretation of ESR values ​​above 100 mm / h. Due to the limitations of the Panchenkov method, domestic clinicians are not familiar with the rules for interpreting an ESR level of more than 80 mm / h. Based on numerous clinical studies, it has been shown that the specificity of the test for pathological conditions increases in proportion to the increase in ESR values, and at levels above 100 mm / h, the number of false-positive results is reduced to zero. The most common causes of such high ESR values ​​are tuberculosis, metastatic tumors and paraproteinemia.The direction of further diagnostic search depends on other clinical data. For example, if a patient over 50 years of age without clinical signs of inflammation has an ESR level of more than 100 mm / h, then the next diagnostic step is to perform electrophoresis of serum proteins in order to detect the monoclonal component. In addition, ESR can be an additional criterion for the differential diagnosis between multiple myeloma (ESR> 50 mm / h) and benign monoclonal gammopathy (ESR
Over the past 20 years, many publications have appeared indicating the possibility of effective use of the ESR indicator for the diagnosis and monitoring of therapy for various pathological conditions.For example, one study demonstrated that detection of ESR> 40 mm / h and C-reactive protein> 60 mg / L in women with suspected pelvic inflammatory disease confirmed the diagnosis in 70%. Moreover, the degree of ESR growth correlated with the severity of the pathological process. Another study showed that an ESR level of more than 37 mm / h in patients with prostate cancer indicates a high risk of disease progression and death. The effectiveness of the use of ESR analysis in the diagnosis and assessment of the prognosis of coronary and cerebrovascular complications of atherosclerosis was studied.It was found that ESR values ​​above 22 mm / h in the group of patients aged 45-65 years are associated with a high risk of developing cardiovascular complications of atherosclerosis. In patients with ischemic stroke, a normal ESR level indicated a rapid recovery of neurological deficit, and ESR values ​​of more than 28 mm / h were associated with a poor prognosis.

What is the analysis used for

  • preventive examination
  • acute and chronic inflammatory processes,
  • infectious diseases
  • oncological diseases
  • autoimmune diseases (diagnosis, prognosis).

Reasons for increased ESR

  • Infectious diseases (usually of bacterial etiology).
  • Inflammatory diseases.
  • Diseases of the connective tissue (rheumatoid arthritis, systemic lupus erythematosus, systemic scleroderma, vasculitis).
  • Inflammatory bowel disease (Crohn’s disease, ulcerative colitis).
  • Oncological diseases (myeloma, lymphogranulomatosis, cancer of various localizations).
  • Myocardial infarction.
  • Anemia.
  • Burns, injuries.
  • Amyloidosis
  • Pregnancy

Reasons for a decrease in ESR

  • Diseases accompanied by a change in the shape of erythrocytes, such as sickle cell anemia or hereditary spherocytosis
  • Polycythemia and conditions that lead to it, such as, for example, chronic heart failure or lung disease.
  • Hypofibrinogenemia.
  • Dehydration.

Critical values ​​of indicators of a general blood test
A strong deviation of some laboratory parameters from the reference values ​​in one direction or another can lead to serious consequences for the patient, including life threatening.