Hematocrit

Book
In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan.
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Excerpt

The term "hematocrit (HCT)" originated from English “hemato-“ and Greek “krites.” HCT measures the volume of packed red blood cells (RBC) relative to whole blood. Hence, it is also known and reported as a packed cell volume (PCV). It is a simple test to identify conditions like anemia or polycythemia and also to monitor response to the treatment. A glass tube and a centrifuge machine are sufficient to measure HCT. After centrifugation, the component of blood separates into three distinct parts. From below upwards, the layers are - a layer of red blood cells (RBC), a layer of white blood cells(WBC) and platelets, and a layer of plasma at the top. This method of determining HCT by Wintrobe hematocrit tube is known as the “macro-hematocrit” method.

A Wintrobe tube is a narrow glass tube measuring 110-mm-long, with graduation from 0 to 100 mm in both ascending and descending order. This method has been succeeded by the “micro-hematocrit” method which uses a small capillary tube instead of a Wintrobe hematocrit tube. It requires less quantity of blood as well as less time requirement for the testing procedure. It is beneficial for patients from whom blood collection is difficult (e.g., pediatric patients/hypovolemia). However, the principle of the test remains the same as the “macro-hematocrit” method. HCT calculation is by dividing the lengths of the packed RBC layer by the length of total cells and plasma. As it is a ratio, it doesn’t have any unit. Multiplying the ratio by 100 gives the accurate value, which is the accepted reporting style for HCT. A normal adult male shows an HCT of 40% to 54% and a female shows 36% to 48%. Though these two methods are still in use in some settings of primary care and medical teachings, they are widely replaced in the majority of settings by an automated analyzer, where HCT reports get generated along with the complete blood count.

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