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Haematocrit is invalid for estimating red cell volume: a prospective study in male volunteers


Jacob, Matthias; Annaheim, Simon; Boutellier, Urs; Hinske, Christian; Rehm, Markus; Breymann, Christian; Krafft, Alexander (2012). Haematocrit is invalid for estimating red cell volume: a prospective study in male volunteers. Blood Transfusion, 10(4):471-479.

Abstract

BACKGROUND: Although haematocrit and haemoglobin value are concentrations, they are commonly used to guide clinical decisions involving red cell and plasma volumes. A study challenging this convention systematically co-determined and compared these measures.
MATERIALS AND METHODS: Using a non-radioactive double-tracer technique to assess blood volume components, measurements were taken once in 46 healthy male endurance athletes. The best predictors of blood composition were derived from the first 36 athletes by automated stepwise forward selection of non-invasive metric parameters (age, weight, height, body surface area and body mass index) and the resulting formulae validated in the remaining ten volunteers. Haematocrit, haemoglobin concentration, red cell volume and plasma volume were measured again 4 weeks later in eight randomly selected volunteers.
RESULTS: Red cell volume (2,282±283 mL) did not correlate with either haematocrit (0.42±0.02) or haemoglobin concentration (14.2±0.8, P>0.05, resp.), but was predictable from body surface area (red cell volume [mL]=1,547 × body surface area [m2]-723; r=.88, P<0.01). A similar accuracy was unobtainable using any potential predictor for plasma or blood volume, haematocrit or haemoglobin concentration. Red cell volume showed high intra-individual stability when measured again after 4 weeks, whereas plasma volume oscillated in both directions by up to 22%.
DISCUSSION: Only red cell volume shows sufficiently stable intra- and interindividual values to be an accurate, objective indicator of normality in blood composition. The measurement technique is feasible in the outpatient setting and this parameter provides effective, robust, and readily available diagnostic information that might be useful in numerous clinical situations. Its clinical significance does, however, remain to be demonstrated.

Abstract

BACKGROUND: Although haematocrit and haemoglobin value are concentrations, they are commonly used to guide clinical decisions involving red cell and plasma volumes. A study challenging this convention systematically co-determined and compared these measures.
MATERIALS AND METHODS: Using a non-radioactive double-tracer technique to assess blood volume components, measurements were taken once in 46 healthy male endurance athletes. The best predictors of blood composition were derived from the first 36 athletes by automated stepwise forward selection of non-invasive metric parameters (age, weight, height, body surface area and body mass index) and the resulting formulae validated in the remaining ten volunteers. Haematocrit, haemoglobin concentration, red cell volume and plasma volume were measured again 4 weeks later in eight randomly selected volunteers.
RESULTS: Red cell volume (2,282±283 mL) did not correlate with either haematocrit (0.42±0.02) or haemoglobin concentration (14.2±0.8, P>0.05, resp.), but was predictable from body surface area (red cell volume [mL]=1,547 × body surface area [m2]-723; r=.88, P<0.01). A similar accuracy was unobtainable using any potential predictor for plasma or blood volume, haematocrit or haemoglobin concentration. Red cell volume showed high intra-individual stability when measured again after 4 weeks, whereas plasma volume oscillated in both directions by up to 22%.
DISCUSSION: Only red cell volume shows sufficiently stable intra- and interindividual values to be an accurate, objective indicator of normality in blood composition. The measurement technique is feasible in the outpatient setting and this parameter provides effective, robust, and readily available diagnostic information that might be useful in numerous clinical situations. Its clinical significance does, however, remain to be demonstrated.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Obstetrics
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2012
Deposited On:15 Jan 2013 11:20
Last Modified:06 Aug 2017 20:40
Publisher:SIMTI Servizi srl
ISSN:1723-2007
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.2450/2012.0111-11
PubMed ID:22682340

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