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17 - Normal values and laboratory methods

Published online by Cambridge University Press:  10 August 2009

By
Pedro A. De Alarcón  and
Eric J. Werner
Edited by
Pedro A. de Alarcón  and
Eric J. Werner
Foreword by
J. Lawrence Naiman
Pedro A. de Alarcón
Affiliation:
University of Tennessee
Eric J. Werner
Affiliation:
Eastern Virginia Medical School
J. Lawrence Naiman
Affiliation:
Stanford University School of Medicine, California
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Summary

Introduction

Profound changes in the normal values for blood components occur during gestation and the first few months of life. The developmental aspects of hematopoiesis must be considered in the evaluation of the neonatal blood picture. Additionally, the timing and site of blood sampling can affect the results. Because of a broad normal range for many factors, the clinician should be aware that the presence of an abnormal condition is not always excluded by a normal laboratory test.

Red blood cell measurements

Complete blood counts (CBC) are performed routinely on automated cell counters, which function by one of two principles: voltage pulse-impedance or light scatter. For the interested reader, the operation of these instruments has been described [1]. The red blood cell count (RBC) and mean cell volume (MCV) are measured directly by these instruments, while the hematocrit is calculated from these values. Alternatively, the hematocrit also can be measured by direct centrifugation of blood in a microhematocrit tube filled by capillary action. Hemoglobin (Hb) is measured directly by automated cell counters [1]. The mean cell hemoglobin (MCH) and mean cell hemoglobin concentration (MCHC) are calculated values. Most automated cell counters also create histograms of red-blood-cell size and determine the red-cell distribution of width (RDW), a quantitative measure of the variation in red-cell size.

Normal values for Hb, hematocrit (Hct), RBC, and indices for fetuses and infants on the first day of life are shown in Table 17.1 [2–4].

Type
Chapter
Information
Neonatal Hematology , pp. 406 - 430
Publisher: Cambridge University Press
Print publication year: 2005

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