RESUMO
PURPOSES: To apply the criteria for classifying the normo- or hypovolaemic state to the blood volume of patients previously diagnosed of relative polycythaemia (RP). PATIENTS AND METHODS: The blood volume of 30 patients previously diagnosed of RP was chosen at random for analysis. Directly measured cell volume (CV) was used to calculate both the total blood volume (WBV) and the plasma volume (PV) of each case expressed as mL and mL/Kg, respectively. WBV was estimated according to Nadler's predictive formula, CV and PV being deductive values expressed in mL. Corrected venous haematocrit (CVH) CV and PV measured as mL/Kg were compared with respective reference intervals of the laboratory (RIL). Weinreb's criteria, modified in accordance to RIL, were used to classify blood volume as normo- or hipovolaemic. RESULTS: Of the 30 patients, 27 were men and 3 women. Mean CVH was 0.51 L/L (range 0.45-0.58 [L/L]). In mL/Kg, 80% of the patients had normal CV with reduced PV, 10% showed normal CV and PV, and the remainders had increased CV with normal PV in 3.3% and decreased PV in 6.7%. Hypovolaemic state was found in 100% of the patients. CONCLUSIONS: Male sex was confirmed as predominant with regard to RP patients. Mean CVH was lower than that of absolute polycythaemia patients, and its wide range stresses the importance of blood volume in the diagnosis of this type of patients, even though reduced PV with normal CV, according to RIL in mL/Kg, are not present. The previous diagnosis was corroborated, hypovolaemic stated being confirmed in all cases at the moment of the study, so more accurate diagnosis and adequate therapeutic indications could be granted, in accordance to the patient's status.
Assuntos
Hipovolemia/diagnóstico , Policitemia/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Tamanho Celular , Feminino , Humanos , Hipovolemia/etiologia , Masculino , Pessoa de Meia-Idade , Volume Plasmático , Policitemia/fisiopatologiaRESUMO
PURPOSE: To assess the blood volume (BV) of children by using different prediction formulas (PF) and to confirm the value of these in providing reference estimates. PATIENTS AND METHODS: The results of BV measurements in 19 children, performed at the Department of Physiology of the Haematology and Immunology Institute, were studied. The children had been sent to this centre to define the diagnosis of anaemia (11 cases) or polycythaemia (8 cases). Four adult and 2 children formulas based on body measurements were applied in order to estimate the reference BV. The relationship between the measured red cell volume (RCV) and plasma volume (PV) and the reference values was calculated for each formula, and the results were evaluated by establishing the normality criteria. RESULTS: The PF used provided reference estimates of the different BV for a given patient. It was found that most adult formulas gave RCV and PV estimates which differ from those of children. PV was commonly decreased with all the formulas. CONCLUSIONS: The different PF provide distinct BV estimates in most patients, and coincidentally the results differ in any given child. The formulas applied to adults, based on weight and height or body surface, should not be applied to estimate the BV in children. The use of equations based on height is recommended, correlating the BV assessment with the results of other studies.
Assuntos
Determinação do Volume Sanguíneo/métodos , Adolescente , Anemia/diagnóstico , Criança , Pré-Escolar , Volume de Eritrócitos , Feminino , Humanos , Lactente , Masculino , Policitemia/diagnóstico , Valor Preditivo dos Testes , Valores de ReferênciaRESUMO
Se informa que se modificará el método biológico in vitro de Bessler y colaboradores (1980), para el estudio de la eritropoyetina (Epo) en el plasma humano, basado en la utilización de cultivos de células hepáticas de embriones de ratones de 12 a 14 días. Se plantea que se determinó la respuesta al estímulo de la Epo de los plasmas en los cultivos, por el incremento del porcentaje de incorporación de la 6H3 timidina al ADN de las células cultivadas. Se expresa que se estudia en el plasma de 37 pacientes; el nivel de la hormona; 9 con diagnóstico de policitemia vera (PV); 16 con policitemia absoluta (PA) pero sin diagnóstico y en 12 enfermos con anemia (Hb < 8g/dl). Se utilizó el plasma de 22 sujetos normales como control. Se señala que el valor promedio del por ciento de incorporación de la 6H3 timidina al ADN para los controles fue de 181 ñ 22. Se expone que en los casos de (PV) este valor fue de 158 ñ 21 para una significación de p< 0,005 y en los pacientes con (PA) sin diagnóstico, fue de 183 ñ 44. Se informa que en este grupo no se encontró significación estadística con el control normal; en los pacientes con anemia el valor promedio es de 242 ñ 56 para una p < 0,005. Se demuestra que de los casos de (PA) sin diagnóstico, 7 presentan valores por debajo de lo normal; 3 de ellos en la actualidad han sido clasificados como (PV) según los criterios diagnósticos internacionales del grupo de estudio de la enfermedad. Se expresa que los patrones de Epo de orina humana no muestran la pureza requerida para los métodos de in vitro. Los resultados obtenidos permiten sugerir el uso de este método para el estudio de la Epo.