HAEMATOCRIT

Packed cell volume Hematocrit literally means blood separation Def:- It is the ratio of the volume of erythrocytes to that of the whole blood. It is expressed as a % or as a decimal fraction. It is one of the most accurate, simple, inexpensive method for the detection and measurement of degree of anemia.

 It enables the calculation of absolute values (ie) red cell indices. ESR value below 60 could be estimated . These are 2 methods of measurement of PCV 1.Manual Macro method using Wintrobe's tube. Micro method using capillary tube. 2.Automated

 Micro method It has the advantage of using capillary blood by finger prick, a short time of centrifugation, better packing of red cells, less error due to trapping of plasma. Here 2/3rd of the tube is filled with capillary or venous blood and the other end sealed with plastic. The tubes are centrifuged at 12000 rpm in a special centrifuge for 5 min

Wintrobe's Tube
It is a glass tube with a flat bottom. It is 100mm long with a calibration in mms with double row of markings upwards for

hematocrit and from above down markings for ESR capacity 1 ml. b) Pasteur pipette with a rubber bulb c) Centrifuge 3000rpm. d) Double oxalated blood (Wintrobe's salt)

 Procedure:- Oxalated blood is taken in Pasteurs pipette. Place tip of pipette in the bottom of Wintrobe tube and fill from the

bottom: raise the pipette the blood goes into avoid air bubbles. Fill upto mark 10. close it with a rubber cap. Then centrifuge at a speed of 3000rpm in a centrifuge 22.5cm radius for 30 minutes.

 Results: 3 layers will separate.

Red cells will occupy the bottom part of the

tube and plasma fills the upper portion. Between the serum& red cells is a thin, yellowish white or gray layer called buffy coat. Buffy coat which consists of white cells other nucleated cells and platelets.

 The platelets are close to the red cell mass. The white cells and nucleated cells face the periphery . The upper most layer of red cell

column contains the reticulocytes and malarial parasites. Since the total column of blood in the tube is to the packed cells could be read directly as a% .

 Ht of red cell column/Ht of total blood volume = 45/100=0.45

Normal 47 7%

45 5% Interpretation:
haematocrit polycythemia vera

 Haemo concentration as seen in shock (surgery trauma burns)

haematocrit Anemia

condition associated with anaemia ex:Cardiac decompensation

Pregnancy Excessive administration of fluids

 Plasma: Normally grayish white or yellowish white

Yellow in jaundice

Reddish hemolysis
Cloudy or milky multiple myeloma Lipaemic states in diabetes & Nephrotic

syndrome.

 Buffy coat:
1mm:10,000 leucocytes/mm >1mm: indicates leukocytosis

<0.5mm: , leucopenia
In regenerative anemia characterised by nucleated red cells and / or an increase in the

number of reticulocytes the separation from erythrocytes & leucocytes is not distinct.

 Note: Sickle cells, macrocytes, microcytes, and schistocytes, the amount of trapped plasma increase to 6% in micro method.

Normal trapping in micro method is 3% MCH Mean concentration Hemoglobin (average amount of Hb in all RBC) Represents the average weight of hemoglobin contained in each cell.

MCH is influenzed by 1) size of the cell 2) the concentration of Hb in the cell.

3) Hbin gm% X10 =pg RBC/C =278-32pg

Hb in gm% X10 = 27-32uugm RBC/mm Eg: Hb : 15gm% RBC = 5X10/L MCH = 15X10 = 30pq 5X10 Below 27 pq = microcytic Hypochromic anemia Above 32 pq + microcytic anemia

 2) MCHC Mean corpuscular Hb concentration

of the degree of satiation of the cells with Hb. Hb in gm% = 31035g/dL HbX100

PCV%

PCV ;32-36% < 31g/dL : Hypochromic anemia. It is an in di cation that the patient should be treated iron. Between 31 & 35 g/dl : Normochromic anemia >35 g/dl : only in spherocytosis.

 Colour index: Expresses the mean Hb content of a single cell as compared with that of arbitrary normal cell Hb% = 14gm of Hb

: 100% RBC% 5 million of RBC 100%

 Normal colour index is % Range 0.85-1.15 The colour index is useful as it divides anemia

into 3 chases 1) High colour index >1.15 : pernicious anemia and other macrocytic anemia 2) Low colour index <0.85 : Iron deficiency anemia

 3) Colour index 0.85 1.15 : Anemia following a recent large Hb Disadvantage of colour index It depends upon the accuracy of RBC counts which is doubtful. It is based on arbitrary standards of normal which takes no account of the cell size. Hence absolute values are used to classify anemia and to guide there.

 Complete blood count ( CBC) : TCC,DCC,RBC count

Hb, Hematocrit

RBC indices
Platelet count Peripheral smear.