treejay Posted November 27, 2012 Share Posted November 27, 2012 Clinically, how do you look at Hct and Hgb values differently? I know the general rule of thumb that Hct is 3 times Hgb. And I've heard you tend to transfuse if Hgb drops below 8 (or Hct of 24). But can one of these values tell you something the other can't, or clinically, are they interchangable? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 27, 2012 Moderator Share Posted November 27, 2012 pretty interchangeable for practical purposes. some folks(like internists) think in hct and get excited when it goes from 30 to 29. other folks(like me) think in hb and get excited when it drops below 9....or in Haiti, below 6...(lots of folks walk around all the time there with 7/21) Link to comment Share on other sites More sharing options...
primadonna22274 Posted November 27, 2012 Share Posted November 27, 2012 Rule of 3 is roughly accurate. Hb is the O2-carrying capacity of RBCs. Hct the volume of cells in blood. Not truly interchangeable as they measure different things but practically can be considered together. Anemia is, strictly speaking, decreased circulating RBCs, but not practical to think of this way so we use H&H. #1 rule of transfusion: transfuse only symptomatic people. Someone acclimated to a Hb of 7.5 is at greater risk of adverse rxn to transfusion than they are from their asymptomatic anemia. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 27, 2012 Moderator Share Posted November 27, 2012 yup, I have seen kids in Haiti running around playing with 5/15. Link to comment Share on other sites More sharing options...
boardreviewnow Posted November 29, 2012 Share Posted November 29, 2012 You guys are all correct but remember that transfusion rules differ in certain disease processes. For example, people with ischemic heart disease should be transfused with a Hgb < 10 in general. Of course you need to weigh the entire clinical picture but if a guy with a CABG has a Hgb of 8.6 you better get the PRBC ready! Link to comment Share on other sites More sharing options...
primadonna22274 Posted November 29, 2012 Share Posted November 29, 2012 ^^^Very true. Look at your patient--not just the lab report ;) Link to comment Share on other sites More sharing options...
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