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Medical Forum / General / Laboratory / March 2007

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At what point do you spin down a CBC and replace plasma with nacl?

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Robthedolphin - 06 Mar 2007 18:58 GMT
I'm wondering at what point you think it is appropriate to spin down a
CBC and replace the plasma with NaCL or isoton.  I've got a patient
with Hgb of 19, but MCH, MCHC and MCV are normal.  Does anyone have an
SOP regarding this?  Is it even allowed under CAP?  Thanks
Manky Badger - 06 Mar 2007 22:04 GMT
> I'm wondering at what point you think it is appropriate to spin down a
> CBC and replace the plasma with NaCL or isoton.  I've got a patient
> with Hgb of 19, but MCH, MCHC and MCV are normal.  Does anyone have an
> SOP regarding this?  Is it even allowed under CAP?  Thanks

Why would you want to ......... ?

Let me guess - you use coulter technology ?
kuhnfucius - 07 Mar 2007 23:52 GMT
Pardon, but the way you stat your question is strange.
I have routinely run infant blood with high H& Hs (e.g. 20 gram +) with no
reason to dilute.
Perhaps I am just behind the times...I don't get out of the local area much
and don't know what CAP check list # you are referring to.    Plasma
replacement (Gange ?, 1977 or something like that) is usually done on
elevated MCHC (e.g. > 37%), after it has been determined that the plasma is
lipemic (hemolysis, not much of a problem anymore) and not a cold agg.. If
the indices are a normal (MCHC 33.3 +/- 3) I am on to the next view.

For those of you who are interested, I have for that washing of the cells
(x2, combined with the usual vortexing) is helpful in marked plt clumping.
My theory is that it dilutes out the EDTA or anticoagulant of choice, thus
lessening the problem.
> I'm wondering at what point you think it is appropriate to spin down a
> CBC and replace the plasma with NaCL or isoton.  I've got a patient
> with Hgb of 19, but MCH, MCHC and MCV are normal.  Does anyone have an
> SOP regarding this?  Is it even allowed under CAP?  Thanks
L C - 08 Mar 2007 13:48 GMT
> I'm wondering at what point you think it is appropriate to spin down a
> CBC and replace the plasma with NaCL or isoton.  I've got a patient
> with Hgb of 19, but MCH, MCHC and MCV are normal.

No need to saline replace with normal indicies.  Some people just have high
hemoglobins ...
 
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