Hemoglobin down, hematocrit normal

Specialties Med-Surg

Published

I was wondering if anyone has come across a patient before who had a hemoglobin drop by 70g/L post op, with only a 0.04 change in Hct? I cannot figure out what may be the cause of this, as post-op bleeding would cause a larger drop in Hct (more correlated to a drop in hemoglobin).

Specializes in Med-Surg, Developmental Disorders.

Hmmm... I'm not an expert, but it is my understanding that hemoglobin indicates the percentage of RBCs in the blood, while the hemoglobin indicates the amount of the specific protein contained in the RBCs which would can bind with oxygen and carry it to the rest of the body. Perhaps while the actual VOLUME (indicated by hemoglobin) changed significantly, the PERCENTAGES (indicated by hematocrit) stayed the same because the components of the remaining blood stayed basically the same, even though there is less of it? Again, not an expert.

ChryssyD

149 Posts

The hematocrit is a percentage of RBC in total blood volume; hemoglobin is a direct measurement of the protein itself. Since hematocrit is a measure of a ratio rather than the hemoglobin itself, the two don't necessarily change equally. But they usually do correlate a bit more closely than your patient's levels. Interesting. My immediate guess is that your patient is dehydrated, but hematology isn't really my strongest suit. What does the doc say?

Specializes in APRN.

This can be seen in dehydration.

heron, ASN, RN

4,137 Posts

Specializes in Hospice.
On 8/1/2017 at 5:41 PM, ChryssyD said:

The hematocrit is a percentage of RBC in total blood volume; hemoglobin is a direct measurement of the protein itself. Since hematocrit is a measure of a ratio rather than the hemoglobin itself, the two don't necessarily change equally. But they usually do correlate a bit more closely than your patient's levels. Interesting. My immediate guess is that your patient is dehydrated, but hematology isn't really my strongest suit. What does the doc say?

 

2 hours ago, susu_24x said:

This can be seen in dehydration.

Yup. Look at bun and creatinine: bun would be high, creatinine normal or near normal if dehydrated.

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