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Thread: The Blood Count

  1. #1
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    Mar 2003

    The Blood Count

    The term "blood count" is often misunderstood by non-medical people. When the term is used by medical professionals it is usually referring to what is called the Complete Blood Count (CBC). This is the calculation of all of the cellular components or formed elements of a person's blood. It includes the number and distribution of the red cells, white cells and platelets, as well as the hematocrit and hemoglobin values. The white cell count is also differentiated into the various types of white cells.

    When non-medical people refer to their "blood count" they are usually referring to just their hemoglobin or hematocrit values. The hematocrit is the ratio of red blood cells to the total blood volume, and is given as a percentage of the whole blood volume. The hemoglobin is the oxygen-carrying molecule within the red blood cells. Its value is given in units of weight, namely, the number of grams of hemoglobin in a liquid measure of blood. In the US and Canada it is grams per deciliter (g/dL), but in Europe grams per liter (g/L) is the preferred scale.

    • The normal hemoglobin values for a male range from 13 g/dL to 18 g/dL, with an average of 15 g/dL.
    • The normal hemoglobin values for a female range from 12 g/dL to 16 g/dL, with an average of 14 g/dL.
    • The normal hematocrit for a male ranges from 45% to 52%, with an average of 48%.
    • The normal hematocrit for a female ranges from 37% to 48%, with an average of 42%.

    In the past, a hemoglobin of 10 g/dL, or a hematocrit of 30% was considered the trigger for the transfusion of red blood cells to correct anemia prior to surgery. However, these days a more conservative approach is favored by many clinicians, and transfusion decisions are now more likely to be made after evaluating the patient's overall condition. Patients without cardiovascular disease, diabetes or other underlying problems have survived with hemoglobin values as low as 1.4 g/dL (See The Transfusion Trigger - Indications for Red Cell Therapy)

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  3. #2
    In a normal adult body there are 4,000 to 10,000 (average 7,000) white blood cells (WBCs), or leukocytes, per microliter[1] of blood. When the number of WBCs increases, this is a sign of an infection somewhere in the body.[2] Antibiotics may be administered to help the immune system fight the infection.
    In people with leukemia, the bone marrow produces abnormal WBCs. These abnormal cells are leukemia[3] cells. They proliferate, and in time may crowd out normal WBCs, as well as red blood cells (RBCs) and platelets. As a consequence of this depletion of RBCs and platelets, the leukemia patient may become anemic and the risk of bleeding—particularly into the brain—may increase. Additionally, the standard treatment for leukemia is chemotherapy which exacerbates the anemia and bleeding risk because of its suppressive effect on the bone marrow, the body’s blood cell factory. Doctors want to address these problems with blood transfusions.
    Normal platelet counts range from 150,000 to 400,000 per cubic milliliter (150 – 400 x 109/L), although many leukemia sufferers will fall well below 20 x 109/L, once considered a trigger for transfusion. Doctors will not usually want to correct a low platelet count by blood transfusion unless the patient is bleeding or the count has fallen below 5 (x 109/L).[4] Anemia remains the biggest concern with leukemia, as with all cancers, and the patient who refuses blood transfusion presents considerable challenges for doctors. What alternatives may be available to these patients will be the subject of a future article in this series.
    See also

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