What is the significance of hematocrit in assessing overall health. How is a hematocrit test performed and interpreted. What conditions can abnormal hematocrit levels indicate. What are the treatment options for polycythemia vera, a condition associated with high hematocrit.

What Is Hematocrit and Why Is It Important?

Hematocrit, often abbreviated as Hct, is a crucial measurement in blood analysis. It represents the percentage of red blood cells in the total blood volume. These cells play a vital role in our health, functioning as the body’s delivery system for oxygen and nutrients. Maintaining the correct proportion of red blood cells is essential for overall well-being.

Healthcare providers often order hematocrit tests as part of a broader health assessment. These tests can help diagnose various conditions or evaluate the effectiveness of ongoing treatments. Some common reasons for ordering a hematocrit test include:

• Suspected anemia
• Possible leukemia
• Dehydration concerns
• Potential dietary deficiencies

It’s worth noting that a hematocrit test is typically included in a complete blood count (CBC), which provides a comprehensive overview of blood cell components.

How Is a Hematocrit Test Performed?

The hematocrit test involves a simple blood draw, which can be done in two ways:

1. A finger prick
2. A venous blood draw, usually from the arm

For a CBC, which includes the hematocrit test, a lab technician will typically draw blood from a vein. The process involves the following steps:

• Cleaning the skin with an antiseptic
• Applying a tourniquet to help the vein swell
• Inserting a needle to collect blood in one or more vials
• Removing the tourniquet and applying a bandage

While some individuals may experience slight discomfort or lightheadedness during the blood draw, the procedure is generally quick and safe. After the test, you can resume your normal activities immediately.

Understanding Hematocrit Test Results

Once the blood sample is collected, it’s sent to a laboratory for analysis. The hematocrit evaluation involves using a centrifuge to separate blood components. After centrifugation, the blood sample separates into three distinct layers:

1. Red blood cells (bottom layer)
2. Anticoagulant (middle layer)
3. Plasma (top layer)

The proportion of red blood cells is then measured and compared to established normal ranges. While specific ranges may vary slightly between laboratories, generally accepted hematocrit ranges are:

• Adult men: 38.8 to 50 percent
• Adult women: 34.9 to 44.5 percent

For children aged 15 and under, normal ranges can vary significantly with age. Healthcare providers use age-specific charts to interpret hematocrit results in pediatric patients.

What Do Abnormal Hematocrit Levels Indicate?

Hematocrit levels outside the normal range can be indicative of various health conditions. Understanding these potential implications is crucial for both patients and healthcare providers.

Low Hematocrit Levels

A hematocrit level below the normal range may suggest:

• Bone marrow disorders
• Chronic inflammatory diseases
• Nutrient deficiencies (iron, folate, or vitamin B-12)
• Internal bleeding
• Hemolytic anemia
• Kidney failure
• Leukemia
• Lymphoma
• Sickle cell anemia

High Hematocrit Levels

Elevated hematocrit levels may indicate:

• Congenital heart disease
• Dehydration
• Kidney tumors
• Lung diseases
• Polycythemia vera

It’s important to note that certain factors can influence hematocrit levels without necessarily indicating a health problem. For instance, living at high altitudes can lead to higher hematocrit levels due to reduced oxygen in the air. Additionally, pregnancy can affect hematocrit readings due to increased fluid volume in the body.

Factors Affecting Hematocrit Test Results

To ensure accurate interpretation of hematocrit test results, healthcare providers need to consider several factors that can influence the readings:

• Recent blood transfusions
• Pregnancy status
• Altitude of residence
• Hydration levels
• Certain medications

Healthcare providers typically evaluate hematocrit results in conjunction with other CBC components and the patient’s overall clinical picture before making a definitive diagnosis.

Risks and Side Effects of Hematocrit Testing

Hematocrit testing is generally considered a low-risk procedure. However, as with any blood draw, there are some minor risks and potential side effects:

• Slight bruising at the puncture site
• Temporary discomfort or throbbing
• In rare cases, prolonged bleeding or swelling

If you experience persistent swelling or bleeding that doesn’t stop within a few minutes of applying pressure to the puncture site, it’s important to inform your healthcare provider promptly.

Polycythemia Vera: A Condition Associated with High Hematocrit

Polycythemia vera (PV) is a rare blood disorder characterized by the overproduction of red blood cells, leading to consistently high hematocrit levels. While there is no cure for PV, various treatment options are available to manage the condition and its complications.

Treatment Options for Polycythemia Vera

The management of polycythemia vera typically involves a combination of approaches:

1. Phlebotomy: Regular blood removal to reduce red blood cell count
2. Medications:
   • Hydroxyurea to slow bone marrow production of blood cells
   • Interferon alfa to stimulate the immune system and slow red blood cell production
   • Ruxolitinib to reduce spleen size and manage symptoms
3. Low-dose aspirin: To reduce the risk of blood clots
4. Lifestyle modifications:
   • Smoking cessation
   • Regular exercise
   • Maintaining a healthy weight

The specific treatment plan for polycythemia vera is tailored to each patient’s individual needs, considering factors such as age, overall health, and the severity of the condition.

The Importance of Regular Hematocrit Monitoring

Regular hematocrit testing plays a crucial role in maintaining overall health and detecting potential issues early. For individuals with chronic conditions or those undergoing specific treatments, routine hematocrit monitoring can provide valuable insights into disease progression or treatment effectiveness.

When Should You Get a Hematocrit Test?

Healthcare providers may recommend hematocrit testing in various scenarios:

• As part of routine health check-ups
• When investigating symptoms of anemia or other blood disorders
• To monitor the effectiveness of treatments for blood-related conditions
• During pregnancy to assess maternal health
• Before and after major surgeries

If you’re concerned about your hematocrit levels or have risk factors for blood disorders, consult with your healthcare provider to determine if testing is appropriate for you.

Interpreting Hematocrit Results in Context

While hematocrit levels provide valuable information about blood composition, it’s essential to interpret these results in the context of other health parameters and clinical findings. Healthcare providers consider several factors when evaluating hematocrit results:

• Other components of the complete blood count (CBC)
• Patient’s medical history and current symptoms
• Recent lifestyle changes or environmental factors
• Concurrent medications or treatments

This comprehensive approach ensures a more accurate assessment of overall health and helps guide appropriate treatment decisions.

Lifestyle Factors Affecting Hematocrit Levels

Several lifestyle factors can influence hematocrit levels, either temporarily or over the long term. Understanding these factors can help individuals maintain healthy hematocrit levels and interpret test results more accurately:

Hydration Status

Dehydration can lead to a temporary increase in hematocrit levels as the blood becomes more concentrated. Conversely, overhydration may result in a slight decrease in hematocrit. Maintaining proper hydration is crucial for accurate test results and overall health.

Diet and Nutrition

Nutritional factors play a significant role in hematocrit levels:

• Iron: Essential for red blood cell production
• Vitamin B12: Necessary for proper red blood cell formation
• Folate: Important for red blood cell maturation

A balanced diet rich in these nutrients can help maintain healthy hematocrit levels.

Physical Activity

Regular exercise, particularly endurance training, can lead to a natural increase in hematocrit levels as the body adapts to increased oxygen demands. This adaptation is generally considered beneficial for overall health and fitness.

Altitude

Living at high altitudes can cause a natural increase in hematocrit levels as the body produces more red blood cells to compensate for lower oxygen levels in the air. This adaptation is normal and doesn’t necessarily indicate a health problem.

Hematocrit and Other Blood Tests: A Comprehensive View

While hematocrit is a valuable indicator of blood health, it’s often most informative when considered alongside other blood tests. Understanding the relationship between hematocrit and other blood components can provide a more comprehensive view of overall health:

Hemoglobin and Hematocrit

Hemoglobin, the protein in red blood cells responsible for carrying oxygen, is closely related to hematocrit. Generally, hemoglobin levels are about one-third of the hematocrit value. Discrepancies between these values can indicate specific blood disorders.

Red Blood Cell Count

The red blood cell count provides information about the number of red blood cells, while hematocrit indicates their volume percentage. Together, these measurements offer insights into red blood cell size and potential abnormalities.

White Blood Cell Count

While not directly related to hematocrit, the white blood cell count can provide context for interpreting hematocrit results, especially when investigating potential blood disorders or infections.

Platelet Count

Platelets play a crucial role in blood clotting. Considering platelet count alongside hematocrit can help healthcare providers assess overall blood health and identify potential bleeding or clotting disorders.

Managing Abnormal Hematocrit Levels

When hematocrit levels fall outside the normal range, healthcare providers may recommend various management strategies depending on the underlying cause:

Low Hematocrit Management

For individuals with low hematocrit levels, treatment approaches may include:

• Iron supplementation for iron-deficiency anemia
• Vitamin B12 injections for pernicious anemia
• Folate supplementation for folate deficiency
• Treating underlying chronic conditions
• In severe cases, blood transfusions may be necessary

High Hematocrit Management

Managing high hematocrit levels often involves addressing the underlying cause:

• Treating dehydration through proper fluid intake
• Managing chronic lung diseases to improve oxygen levels
• Phlebotomy (blood removal) for conditions like polycythemia vera
• Addressing sleep apnea to improve oxygen saturation during sleep

In all cases, regular monitoring and follow-up with healthcare providers are essential to ensure effective management and prevent complications.

Hematocrit in Special Populations

Hematocrit levels and their interpretation can vary in certain populations, requiring special consideration:

Pediatric Patients

Children’s hematocrit levels change rapidly with age. Healthcare providers use age-specific charts to interpret results accurately. Factors such as growth spurts, dietary changes, and developmental stages can influence hematocrit levels in children.

Pregnant Women

During pregnancy, blood volume increases, potentially leading to a relative decrease in hematocrit levels. Healthcare providers monitor hematocrit closely during pregnancy to ensure adequate oxygen-carrying capacity for both mother and fetus.

Elderly Individuals

Older adults may experience natural declines in hematocrit levels due to decreased bone marrow function. However, significant drops may still indicate underlying health issues and should be investigated.

Athletes

Endurance athletes often have naturally higher hematocrit levels due to training adaptations. However, extremely high levels may raise concerns about potential blood doping in competitive sports.

Future Directions in Hematocrit Research and Diagnostics

As medical science advances, new approaches to hematocrit testing and interpretation are emerging:

Point-of-Care Testing

Rapid, portable hematocrit testing devices are being developed, allowing for quick results in various healthcare settings. These innovations could improve access to testing and enable more timely treatment decisions.

Artificial Intelligence in Result Interpretation

Machine learning algorithms are being explored to assist in interpreting hematocrit results in conjunction with other health data. This approach could lead to more accurate diagnoses and personalized treatment plans.

Genetic Factors Influencing Hematocrit

Ongoing research is investigating genetic variations that may influence hematocrit levels. Understanding these genetic factors could lead to more targeted approaches in managing blood disorders.

Non-Invasive Monitoring Techniques

Researchers are exploring non-invasive methods for monitoring hematocrit levels, potentially reducing the need for frequent blood draws in patients requiring regular testing.

As our understanding of hematocrit and its implications for health continues to evolve, these advancements promise to enhance the diagnostic value and clinical utility of hematocrit testing.

Hematocrit Test: Uses, Procedure, and Results

What is hematocrit?

Hematocrit is the percentage of red blood cells in the total blood volume. Red blood cells are vital to your health. Imagine them as the subway system of your blood. They transport oxygen and nutrients to various locations in your body. For you to stay healthy, your body needs to have the correct proportion of red blood cells.

Your doctor may order a hematocrit, or Hct, test if they think you have too few or too many red blood cells.

A hematocrit test can help your doctor diagnose you with a particular condition, or it can help them determine how well your body is responding to a certain treatment. The test can be ordered for a variety of reasons, but it’s most often used to test for:

• anemia
• leukemia
• dehydration
• dietary deficiencies

If your doctor orders a complete blood count (CBC) test, the hematocrit test is included. Other tests in a CBC are a hemoglobin and reticulocyte count. Your doctor will look at your overall blood test results to gain an understanding of your red blood cell count.

Learn more: CBC (complete blood count) »

First you will receive a blood test. Afterward, it will be sent to a laboratory for evaluation.

Blood sample

A medical provider will need a small sample of blood to test your hematocrit. This blood can be drawn from a finger prick or taken from a vein in your arm.

If the hematocrit test is part of a CBC, a lab technician will draw blood from a vein, typically from the inside of your elbow or from the back of your hand. The technician will clean the surface of your skin with an antiseptic and place an elastic band, or tourniquet, around your upper arm to help the vein swell with blood.

They’ll then insert a needle in the vein and collect a blood sample in one or more vials. The technician will remove the elastic band and cover the area with a bandage to stop the bleeding. A blood test can be slightly uncomfortable. When the needle punctures your skin, you might feel a prick or pinching sensation. Some people also feel faint or lightheaded when they see blood. You may experience minor bruising, but this will clear up within a few days. The test will take only a few minutes, and you can resume everyday activities after it’s finished. Your sample will be sent to a lab for analysis.

Evaluation

In the laboratory, your hematocrit is evaluated using a centrifuge, which is a machine that spins at a high rate to cause the contents of your blood to separate. A lab specialist will add a special anticoagulant to keep your blood from clotting.

When the test tube is taken out of the centrifuge, it will have settled into three parts:

• red blood cells
• anticoagulant
• plasma, or the fluid in your blood

Each component will settle in a different part of the tube, with the red blood cells moving to the bottom of the tube. The red blood cells are then compared to a guide that tells what proportion of your blood they make up.

While the laboratory that tests the blood sample may have its own ranges, generally accepted ranges for hematocrit depend on your gender and age. Typical ranges are as follows:

• adult men: 38.8 to 50 percent
• adult women: 34.9 to 44.5 percent

Children ages 15 and under have a separate set of ranges, as their hematocrit levels change rapidly with age. The specific lab that analyzes the results will determine the normal hematocrit range for a child of a certain age.

If your hematocrit levels are too low or too high, it can indicate various problems.

Low hematocrit levels may be a sign of:

• bone marrow diseases
• chronic inflammatory disease
• deficiencies in nutrients such as iron, folate, or vitamin B-12
• internal bleeding
• hemolytic anemia
• kidney failure
• leukemia
• lymphoma
• sickle cell anemia

High hematocrit levels can indicate:

• congenital heart disease
• dehydration
• kidney tumor
• lung diseases
• polycythemia vera

Before getting the test, let your doctor know if you’ve recently had a blood transfusion or are pregnant. Pregnancy can decrease your blood urea nitrogen (BUN) levels due to increased fluid in your body. A recent blood transfusion can also affect your results. If you live at a high altitude, your hematocrit levels tend to be higher due to reduced amounts of oxygen in the air.

Your doctor will likely compare the results of your hematocrit test to the other parts of the CBC test and your overall symptoms before making a diagnosis.

A hematocrit test is not associated with any major side effects or risks. You may have some bleeding or throbbing at the site where the blood is drawn. Let your doctor know if you experience any swelling or bleeding that doesn’t stop within a few minutes of pressure being applied to the puncture site.

How is Polycythemia Vera Treated?

Polycythemia vera (PV) doesn’t have a cure. However, treatments can help control the disease and its complications. PV is treated with procedures, medicines, and other methods. You may need one or more treatments to manage the disease.

Goals of Treatment

The goals of treating PV are to control symptoms and reduce the risk of complications, especially heart attack and stroke. To do this, PV treatments reduce the number of red blood cells and the level of hemoglobin (an iron-rich protein) in the blood. This brings the thickness of your blood closer to normal.

Blood with normal thickness flows better through the blood vessels. This reduces the chance that blood clots will form and cause a heart attack or stroke.

Blood with normal thickness also ensures that your body gets enough oxygen. This can help reduce some of the signs and symptoms of PV, such as headaches, vision problems, and itching.

Studies show that treating PV greatly improves your chances of living longer.

The goal of treating secondary polycythemia is to control its underlying cause, if possible. For example, if the cause is carbon monoxide exposure, the goal is to find the source of the carbon monoxide and fix or remove it.

Treatments To Lower Red Blood Cell Levels

Phlebotomy

Phlebotomy (fle-BOT-o-me) is a procedure that removes some blood from your body. For this procedure, a needle is inserted into one of your veins. Blood from the vein flows through an airtight tube into a sterile container or bag. The process is similar to the process of donating blood.

Phlebotomy reduces your red blood cell count and starts to bring your blood thickness closer to normal.

Typically, a pint (1 unit) of blood is removed each week until your hematocrit level approaches normal. (Hematocrit is the measure of how much space red blood cells take up in your blood.)

You may need to have phlebotomy done every few months.

Medicines

Your doctor may prescribe medicines to keep your bone marrow from making too many red blood cells. Examples of these medicines include hydroxyurea and interferon-alpha.

Hydroxyurea is a medicine generally used to treat cancer. This medicine can reduce the number of red blood cells and platelets in your blood. As a result, this medicine helps improve your blood flow and bring the thickness of your blood closer to normal.

Interferon-alpha is a substance that your body normally makes. It also can be used to treat PV. Interferon-alpha can prompt your immune system to fight overactive bone marrow cells. This helps lower your red blood cell count and keep your blood flow and blood thickness closer to normal.

Radiation Treatment

Radiation treatment can help suppress overactive bone marrow cells. This helps lower your red blood cell count and keep your blood flow and blood thickness closer to normal.

However, radiation treatment can raise your risk of leukemia (blood cancer) and other blood diseases.

Treatments for Symptoms

Aspirin can relieve bone pain and burning feelings in your hands or feet that you may have as a result of PV. Aspirin also thins your blood, so it reduces the risk of blood clots.

Aspirin can have side effects, including bleeding in the stomach and intestines. For this reason, take aspirin only as your doctor recommends.

If your PV causes itching, your doctor may prescribe medicines to ease the discomfort. Your doctor also may prescribe ultraviolet light treatment to help relieve your itching.

Other ways to reduce itching include:

• Avoiding hot baths. Cooler water can limit irritation to your skin.
• Gently patting yourself dry after bathing. Vigorous rubbing with a towel can irritate your skin.
• Taking starch baths. Add half a box of starch to a tub of lukewarm water. This can help soothe your skin.

Experimental Treatments

Researchers are studying other treatments for PV. An experimental treatment for itching involves taking low doses of selective serotonin reuptake inhibitors (SSRIs). This type of medicine is used to treat depression. In clinical trials, SSRIs reduced itching in people who had PV.

Imatinib mesylate is a medicine that’s approved for treating leukemia. In clinical trials, this medicine helped reduce the need for phlebotomy in people who had PV. This medicine also helped reduce the size of enlarged spleens.

Researchers also are trying to find a treatment that can block or limit the effects of an abnormal JAK2 gene. (A mutation, or change, in the JAK2 gene is the major cause of PV.)

Source: National Heart, Lung, and Blood Institute, National Institutes of Health.

norm in a child, women, men, causes of increased, decreased values ​​in the blood

Hematocrit is one of the blood indicators that registers the total volume of all formed elements, and these are erythrocytes, leukocytes and platelets, in relation to the total volume. Moreover, 99% of the volume of all these elements falls on erythrocytes. The hematocrit (Ht) is expressed as a percentage, but a liter per liter (L/L) can also be selected.

Human blood contains from 36 to 48% of formed elements, it also contains plasma, water, proteins, carbohydrates and salts.

Hematocrit is determined simply: a certain amount of blood is poured into a special tube with graduation, then it is sent to a centrifuge, and at the end of the process, the fraction of the length of the tube that was filled with erythrocyte mass is determined. Also, laboratories now use automatic hematology analyzers that allow you to get data in just a few minutes.

Blood hematocrit norm

The body of an adult healthy person contains about 5 liters of blood. Erythrocytes, leukocytes and platelets cannot be called cells, they do not have the necessary parameters for this. Therefore, they are called formed elements. Different people have different amounts of these elements per liter of blood. For example, according to statistics, the hematocrit in men is higher and equal to 40-41%, sometimes this figure can reach 51%.

Hematocrit in women is slightly lower and usually ranges from 36-42%. The reason for this is such a physiological feature as menstruation. As for the period of pregnancy, here this figure begins to decrease in the second half, and this is also not a pathology.

Hematocrit in children always depends on age, therefore, before drawing conclusions from the analysis, it is necessary to find out how many months or years the baby is. In newborn babies, this figure can be equal to 44-62%, at the age of 3 months it decreases and the figure becomes up to 44%, from 3 months to 1 year the figures can range from 32 to 43%. In the first ten years, Ht in boys can rise to 52%, and in girls it can be at around 35-47%. In subsequent years, the hematocrit norm is equal to the same indicator that is recorded in adults.

Causes of increased hematocrit

Why can it happen that the hematocrit in the blood test is elevated? There are pathological and physiological causes, so before starting any treatment, it is important to understand their origin.

Pathological causes include the following diseases and conditions:

1. Dehydration (dehydration). Due to the fact that the amount of blood that circulates through the vessels decreases, the formed elements are in a more concentrated state. This happens with vomiting, diarrhea, heavy sweating, overheating, lack of fluid.
2. Second and third degree burns. In this case, blisters appear on the body, which are filled with plasma, and it appeared in them from the bloodstream. Therefore, the blood becomes thicker, and the concentration of formed elements increases.
3. Peritonitis, thrombosis or diabetes mellitus.
4. Chronic hypoxia.
5. Regular use of glucocorticosteroids or diuretics.
6. Kidney disease – hydronephrosis.
7. Almost all blood diseases, including leukemia.
8. Polycystic.
9. Heart defects, ischemic heart disease.
10. Erythremia.
11. Many lung diseases, including asthma, bronchitis.
12. Severe bleeding.

However, hematocrit analysis alone is not enough to make an accurate diagnosis, it is not very informative. Therefore, it is often done as part of a general blood test, and further therapy tactics are already built on it, if it turns out to be necessary.

But elevated hematocrit can also be the result of certain physiological phenomena. In this case, deviations of this indicator cannot be considered pathological. High Ht in comparison with the norm is detected in people who smoke constantly and for a long time, which is associated with the development of chronic oxygen starvation of tissues and increased production of red blood cells.

Residents of high mountain regions and mountaineers who spend a lot of time at altitude also have Ht in the range of 51-52%. This is all connected with the same oxygen starvation and the need for the body to compensate for this lack. Also, elevated Ht is typical for athletes who take anabolics that help them gain the required amount of muscle mass.

Manifestations and symptoms of elevated hematocrit

If the hematocrit in the blood is elevated, then this will not necessarily be expressed by certain symptoms. However, it should be remembered that this condition is always expressed by an increase in blood viscosity, which creates a great threat for the formation of blood clots and clogging of both small and large vessels.

If this happens in the coronary arteries, then myocardial infarction develops against the background of thrombosis. If a thrombus forms in the pulmonary artery, then death occurs in 70% of all cases. If the arteries of the brain are affected, then this leads to the development of an ischemic stroke. With thrombosis of the vessels of the legs, gangrene begins to develop.

Therefore, it is important to find out the cause of elevated Ht as soon as possible and start timely treatment.

Reasons for low hematocrit

A decrease in hematocrit can occur without any pronounced symptoms, so this result is usually detected after a blood test and is an unexpected discovery for a person.

The main reasons why the hematocrit may be low are:

• virtually all anemias, including iron deficiency, folate deficiency, B12 deficiency;
• violation of the production of red blood cells due to pathologies of the bone marrow, including oncological ones;
• cirrhosis of the liver;
• diseases of the urinary system;
• hemolysis or destruction of red blood cells;
• chronic bleeding;
• increase in circulating blood volume;
• hyperproteinemia;
• lead intoxication;
• acute infections;
• the use of anticoagulants and similar drugs that affect the composition of the blood.

Decreased hematocrit may have physiological causes. This is work associated with a long stay in one position, starvation or adherence to strict diets, a large amount of fluid that enters the body, alcoholism, the use of large amounts of salt, the period of menstruation.

Manifestations and symptoms of low hematocrit

The reasons for the drop in hematocrit will directly affect what symptoms a person experiences. For example, if it is anemia, then there will be such complaints:

• headache and constant weakness;
• impaired consciousness and breathing;
• dizziness, nausea or vomiting;
• constant thirst;
• lack of strength and exercise intolerance.

If the cause is kidney and urinary system diseases, then there will be complaints about a decrease in the amount of urine excreted, pain in the lumbar region, urination disorder, and changes in blood pressure.

With cirrhosis of the liver, complaints will be of pain in the right side of the abdomen under the ribs, the appearance of spider veins on the skin, indigestion, excessive formation of gases, a feeling of fullness in the abdomen, in advanced cases – internal bleeding.

What tests are needed?

To find out the relative content of all formed elements in the blood, it is necessary to analyze the hematocrit. It is done as part of a general blood test (CBC), when, together with Ht, the number of all elements is calculated, and the ESR is also determined.

Usually, it is with the KLA that a patient’s examination begins to identify a particular disease, or it is carried out for preventive purposes as part of a medical examination, medical examination.

Both venous blood and capillary fingerstick blood can be used for analysis. It is best to take the test in the morning, before breakfast. This allows you to get the right readings that will help the doctor determine if Ht is elevated or low, or its values ​​are within the normal range.

Hemoabdomen. Methods of diagnosis and treatment.

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Experimental Therapy Clinic N.N. Blokhin RAMS with OOO “Biocontrol”, Anesthesiological Veterinary Society VITAR
Kuznetsova A. L., Ph.D. Kornyushenkov E.A., Ph.D. Lissitskaya K.V.

The term “Hemoabdomen” and “Hemoperytoneum” means an abnormal accumulation of blood in the abdominal cavity.

Hemoabdomen can be caused by damage to internal organs, rupture of abdominal tumors, or coagulation disorders. Stabilization of patients with Hemoabdomen is non-specific, while specific treatment may vary depending on the cause of the bleeding. If Hemoabdomen is caused by blood clotting disorders, then surgical treatment is contraindicated. Hemoabdomen caused by a tumor process is subject to surgical treatment in the form of excision of this neoplasm (if possible). Patients with intra-abdominal bleeding caused by trauma can often be treated conservatively.

Diagnosis of Hemoabdomen is based on clinical signs, imaging findings and/or laparocentesis. In the presence of even a small volume of fluid in patients with signs of an acute abdomen, aspiration and analysis of the fluid is indicated. The puncture is carried out according to the 4-square system, retreating 2-3 cm from the navel. Immediate laparocentesis allows diagnosing Hemoabdomen in about 60% of cases. A false positive result can be obtained in the case of puncture of the spleen, liver or other abdominal organs. These causes can be easily ruled out, since blood that has been in contact with the serosa does not clot due to a decrease in the amount of fibrinogen and platelets. With Hemoabdomen, the aspirated fluid is hemorrhagic in nature. The liquid obtained by laparocentesis is divided into portions: 1) to determine hematocrit, cytosis and conduct a cytological study; 2) for biochemical research; 3) if necessary, bacteriological examination. The diagnosis of “Hemoabdomen” can be made if the abdominal hematocrit is equal to or even higher than the hematocrit of the blood. Hemorrhagic fluid with a lower hematocrit can be obtained, for example, in Uroabdomen, peritonitis, ascites, which can be differentiated by biochemical analysis of ascitic fluid. Thus, it is possible to diagnose an injury to the bladder, gallbladder, etc. When used to diagnose peritoneal lavage, a hematocrit >5% in the lavage fluid is an indicator of Hemoabdomen, which can be of great importance in peritoneal dialysis.

Treatment for Hemoabdomen can be either conservative or surgical. Minor abdominal bleeding may occur spontaneously and not be accompanied by severe clinical symptoms. If the patient cannot be stabilized conservatively, surgery is required.

Fluid therapy and analgesia are important therapeutic parts in the management of all patients, regardless of the therapeutic or surgical treatment strategy. Massive abdominal bleeding can lead to the development of hypovolemic shock.

The goal of fluid therapy is to normalize tissue perfusion and oxygen supply in patients with abdominal bleeding. Infusions include bolus administration of 10-20 ml/kg of crystalloid solutions, 5-10 ml/kg of colloids. With massive blood loss (hematocrit 20-25%), hemotransfusion is necessary (whole blood, erythrocyte mass, plasma). The ability of blood products to maintain oxygen supply becomes especially important in the event of an acute loss (up to 35%) of an animal’s blood volume. Allotransfusion is acceptable (provided the bleeding is not caused by cancer) if other blood products are not available. Oxygen therapy is an important part of anti-shock therapy in patients with Hemoabdomen.

An important step to prevent further bleeding is to normalize blood clotting and achieve a blood pressure of approximately 100/60 mmHg. Maintaining this level reduces the risk of rebleeding and ensures adequate tissue perfusion. Coagulation disorders are treated with vitamin K (5 mg/kg loading dose) and plasma (10-15 ml/kg IV). In the event of severe blood loss, plasma may be given as part of bolus fluid therapy. In all other cases, it should be administered within 2-4 hours.

Analgesia is best administered with opioids (eg butorphanol 0.2-0.8 mg/kg) in combination with a continuous infusion of lidocaine. Lidocaine is given as a bolus of 2 mg/kg (cats 0. 5 mg/kg) followed by 30-50 mcg/kg/min (approximately 2-4 mg/kg/h). With prolonged use (more than 24 hours), animals may become sedated and the dose must be reduced. In cats, this pain management tactic is rarely used due to the high toxicity of lidocaine to this species.

Depending on the cause of the Hemoabdomen, patients are treated surgically or non-surgically after stabilization.

Conservative treatment includes fluid therapy, analgesia, oxygen therapy, antibiotic therapy, blood transfusion and is similar in general features to patient stabilization. Careful monitoring of perfusion parameters is necessary.

In case of disease progression, a decision on surgical intervention may be necessary to stop bleeding. Indications for surgery include ongoing symptoms of shock despite fluid resuscitation and analgesia, rapid abdominal expansion, worsening after an initial positive response to conservative therapy, and evidence of continued bleeding on laparocentesis. Animals that are indicated for surgical treatment will require more blood products compared to animals not subject to surgery.