What does high and low hematocrit mean in children? Pediatric questions: how to treat low hematocrit in an infant? The hematocrit is lowered in a 7-year-old child.

The most important thing in a person's life is health, and the health of a child is doubly important for parents. In the article we will tell you what hematocrit is, what are the norms of this blood indicator for children of different ages, and also answer questions about low and high hematocrit.

What shows

Hematocrit is an indicator that determines the content of red blood cells (erythrocytes) in its total volume. Measured in percentage. It is determined by a general blood test. Hematocrit measures the ability of blood to carry oxygen to body tissues. Currently, laboratories are equipped with automated equipment that independently determines the level of hematocrit in the blood. However, even 10–15 years ago, laboratory assistants had to centrifuge a special glass graduated tube with blood, and after the formed elements settled at the bottom, and the plasma occupied the upper part of the tube, determine the hematocrit level on a graduated scale.

Video: what do the indicators in the general blood test say

Norms for children of different ages

We give in the table the indicators of the normal level of hematocrit, determined by A. Wayne in 1997 for healthy children of different ages.

Elevated hematocrit

Elevated hematocrit is normally determined in newborn children. The hematocrit increases by two main mechanisms: an increase in blood plasma relative to blood plasma and a decrease in the amount of blood plasma in relation to blood cells. Outwardly, these mechanisms manifest themselves in different ways. Let's look at the main situations of increased hematocrit and their external manifestations.

An increase in hematocrit is possible in several cases.

hypoxia

What should be the normal level of platelets in children and the consequences of deviations from the norm are described in the article

In children, the most common causes of hypoxia - lack of oxygen - are a long anhydrous period in childbirth, as well as diseases of the respiratory system. In such a stressful, anoxic situation, the body begins to produce more red blood cells to increase hemoglobin, so the hematocrit rises. The mechanism of increase is that the content of blood cells increases with a relatively constant amount of plasma (liquid part) of the blood. Outwardly, this is often manifested by reddening of the skin..

As a rule, this condition occurs during the neonatal period and is normal: the baby undergoes adaptation after the intrauterine period. In this case, an increase in hematocrit is not pathological and does not require treatment.

Dehydration

The most common cause of dehydration (dehydration of the body) is acute intestinal infections, diseases of the gastrointestinal tract, and burns. In this situation, the mechanism of hematocrit increase is directly opposite to hypoxia: with a relatively constant amount of formed elements, blood plasma (the liquid part) is lost, and, accordingly, hematocrit increases.

Symptoms:

• pallor;
• dry skin;
• weight loss;
• feeling of thirst.

Dehydration can be critical for a child's life, the main indicator is a weight loss of more than 3%, in which case you should immediately consult a doctor.

If the dehydration is mild, then at home the treatment will consist in soldering with electrolyte solutions (for example, based on the drug Regidron). It is necessary to follow certain rules - drinking should be given often, but in a small amount. You should not “fill” a liter of liquid per hour into a child: it will cause nothing but vomiting. But a few sips every 10-15 minutes during the day and a good sleep will help restore the child to good health. It is also necessary to carefully monitor urination, the child should not lose more than 80% of the liquid drunk. When dehydrated, a child loses more fluid than they take in. In the clinic, infusion therapy (droppers) is performed to restore the lost fluid.

Blood diseases

Hematocrit can also increase in case of coagulation disorders - in case of blood diseases that are associated with an increase in its coagulability and density. The mechanism for increasing hematocrit is an increase in blood cells relative to plasma. A coagulation disorder is usually diagnosed when bleeding or rash develops. elevated hematocrit in this case occurs in the course of confirming the diagnosis.

Decreased hematocrit

The mechanism of low hematocrit is reversed: hematocrit will be reduced in cases where the number of formed elements decreases with a normal amount of plasma, or when the plasma volume increases in relation to the normal amount of formed elements. External manifestations of low hematocrit may be different. There are also several reasons for the decrease in hematocrit.

Hyperhydration

This is the opposite situation of dehydration, when there is excess fluid in the body. The most common reason for childhood it occurs due to a malfunction of the kidneys.

The most common manifestation is edema. Edema can be determined both on the face and on the legs. In addition, hidden edema can be detected in a child - the so-called “rubber bands” symptom, when socks leave pronounced impressions on the skin in the evening.

The mechanism of lowering the hematocrit level here is associated with an increase in the volume of blood plasma with a normal number of red blood cells. Herbal medicine can be carried out at home: give the child various diuretic preparations to drink for 1-2 weeks, but only if the edema is not very pronounced and the child is not bothered by anything. As in the case of dehydration, it is necessary to monitor urination.

Anemia

Anemia can be of different types. The most common are the following.

1. Deficiency (iron deficiency, folate deficiency, B12 deficiency). They are associated with a lack of trace elements in the body, resulting in a decrease in the number of blood cells, hence the decrease in hematocrit. Treatment consists in restoring the balance of vitamins and trace elements in the body. Sometimes it is quite enough to drink 1-2 courses of multivitamins, but if the nature of anemia is precisely known, iron, folic acid or vitamin B12 preparations are prescribed.
2. - due to bleeding. They, as a rule, are not characteristic of childhood, but may occur as complications after surgical interventions. They are treated exclusively in a hospital under the strict supervision of doctors. Most effective treatment- transfusion of blood components, red blood cells and/or fresh frozen plasma.
3. aplastic anemia. This type is most typical for childhood. As a result of bone marrow dysfunction, the formation of blood cells decreases against the background of a relatively constant amount of plasma, hence a decrease in hematocrit occurs. They are detected during regular examinations by a pediatrician and the collection of a general blood test.

Hyperproteinemia

What is a blood test for fibrinogen and why should it be taken is described in the article

This is an increased amount of protein in the blood plasma, the protein, as it were, attracts intercellular fluid into the bloodstream, the density of the blood decreases, and the hematocrit also decreases. This often happens when feeding children with cow's or goat's milk, in which the protein content is much higher than in breast milk. Accordingly, the most appropriate treatment would be the appointment of breastfeeding. In situations where breastfeeding is not possible, formulas with a low protein content should be sought.

Although the hematocrit is not the main indicator in the complete blood count, a change in its normal values ​​will serve as an indicator that something is going wrong in the body. If you are concerned about the condition of the child, for example, he has pale skin or, on the contrary, redness is observed, the baby often asks for water or you notice swelling - contact your pediatrician. The doctor will prescribe a complete blood count, which will show if there are any reasons for concern. Be healthy!

We were going to vaccinate the child the other day. Got tested today. Leukocytes are lowered - 4.8 at the norms of children's analysis of 6.0-17.5. A month ago, leukocytes were 7.6. Twitched to read what it means. Already thrown into a cold sweat ... Diseases of the blood, bone marrow ... I'm already shaking. What to do and where to run? It is pointless to run to the pediatrician, she is not competent ...

Help with deciphering the blood test and scatology, there are deviations from the norm

Girls, you need advice from a knowledgeable person. The child is 1 year and 5 months old. They didn’t take tests for a year, they passed now. Urine - the analysis is good, but in the analysis of blood and scatology - deviations (highlighted in red). Moreover, in the blood test, which was taken six months ago, lymphocytes were also increased, neutrophils were lowered (everything was ok with erythrocytes). We'll go to the doctor, but before going to the doctor, I would like to figure out what it could be connected with, so that the doctor could add. ask questions. Thanks!

Hematocrit is a laboratory indicator that reflects the ratio of red blood cells to the total volume of blood. It changes with pathologies of the red bone marrow and some diseases of the internal organs. The results are recorded as a percentage, and the rate depends on the age of the child. When the doctor reveals that the hematocrit in the child is lowered, additional diagnostic procedures are prescribed. This allows you to identify the causes of the change and choose the necessary treatment.

The norm in children

Indicators of the norm of hematocrit in the blood depend on the age of the child. For example:

• in newborns, values ​​can range from 44 to 62%. The big difference is due to the gradual replacement of fetal RBCs by adults;
• at the age of 3 months, the norm is 32-44%. Fluctuations become smaller, as the work of the hematopoietic system normalizes;
• at 1-2 years hematocrit is 36-44.

After 2 years of age, changes in hematocrit are not typical. It becomes stable clinical analysis blood and can be easily used to diagnose pathologies.

Reasons for the downgrade

Hematocrit reflects the rheological properties of blood. They are associated with its density and depend on the number of shaped elements. If the indicator increases, then there are more red blood cells and the blood thickens. With its decrease, the plasma volume begins to predominate.

The reasons for the decrease in hematocrit in childhood include:

• anemia is the most common pathology leading to a decrease in hematocrit. The disease has other signs: the average volume of red blood cells decreases, which is associated with a decrease in the concentration of hemoglobin in them;
• severe acute or chronic blood loss;
• rapid destruction of red blood cells against the background of congenital anomalies of their structure or acquired diseases;
• taking a large amount of liquid, as well as long-term infusion therapy;
• an increase in the concentration of protein in the blood.

In some children, a decrease in hematocrit may not be associated with diseases. Such changes are typical after heavy physical exertion or emotional stress.

To prevent false results, doctors recommend adhering to the following principles for preparing for blood donation:

• if the child has had nosebleeds in the last 7-10 days, after tooth extraction or for other reasons, then the analysis should be postponed;
• the day before blood donation, any physical exercise, including visiting sports sections and physical education lessons at school;
• it is necessary to exclude stressful situations;
• when conducting infusion therapy, the analysis is postponed for 1-2 days;
• It is not recommended to drink large amounts of fluid per day and on the day of the study.

The exclusion of these factors allows to obtain reliable results. Only the attending physician interprets them. Incorrect diagnosis is the reason for the progression of diseases and the development of their complications.

Possible consequences

Red blood cells are cells that transport oxygen to the internal organs and the brain. When the hematocrit is lowered in a child, this may indicate a decrease in their number. In this case, children experience the following symptoms:

• blanching of the skin. In children under one year old, they may have a "marble" hue;
• weakness that occurs against the background of any physical or mental work;
• tachycardia not associated with other diseases.

In cases where changes in the blood remain undetected for a long time and the child does not receive therapy, they lead to organic changes. Against the background of cerebral hypoxia, the child experiences learning difficulties - he cannot concentrate on educational material for a long time, forgets information and formulates answers to the teacher's questions for a long time. Also, a lag is formed in physical development, since children are not able to engage in physical education classes together with their peers. In severe cases, dystrophic processes develop during internal organs, which can cause symptoms of diseases of the heart, kidneys, lungs, etc.

It is important to understand that a change in hematocrit is not an indication for starting any treatment. The doctor conducts an additional examination of the child, as well as laboratory and instrumental methods, identifying the cause of the deviation of the indicator. After it is installed, complex therapy is prescribed.

Parents, seeing a decrease in hematocrit in the results of their child's analysis, often worry about what this means and what measures should be taken to correct it. Doctors note that the deviation of the indicator does not indicate serious pathologies, but may be associated with lifestyle, nutrition, or iron deficiency anemia. The main task of parents is to visit a doctor in a timely manner and follow his instructions.

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A general blood test is performed to determine the child's health status. This analysis is carried out to control blood flow and exclude the possibility of changes in blood parameters. The hematocrit is lowered in a child for a variety of reasons, its design depends on age, gender and some other physiological characteristics of the body. If a deviation was detected in children, then it is necessary to respond to changes in a timely manner.

The norm and what is the deviation

Immediately after the birth of a child, his analyzes are studied in detail. This is done in order to exclude the possibility of congenital pathologies. Do not forget that in a child at 3 months the composition of the blood cannot be the same as in an adult.

Over time, the child's body begins to adapt to the outside world, and the composition of the cells begins to change. For a newborn, the hematocrit should be 44-62%, which is a higher value compared to an adult.

During the first 8-10 years, the indicator can be low or high, 37-44% is considered the norm. Changes begin when a child enters puberty. During this period, it is recommended to periodically take tests to constantly monitor the composition of the blood, since it should not be too thick.

Children under one year of age are periodically tested. This is due to the fact that changes can occur almost every week. After blood donation is performed every few years. At breastfeeding the state of the mother also affects the child's body.

How often do you take a blood test?

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Only by prescription of the attending physician 30%, 949 votes

Once a year and I think it's enough 18%, 554 vote

At least twice a year 15%, 460 votes

More than twice a year but less than six times 11%, 344 vote

I monitor my health and take it once a month 6%, 197 votes

I'm afraid of this procedure and try not to pass 4%, 135 votes

21.10.2019

A drop below 25% indicates that the blood is too thin or blood loss occurs in the body. To determine the reasons, repeated tests are carried out.

Why is the level lowered

A decrease in hematocrit in a child can occur for a variety of reasons. The most common are the following:

• Violations occurring in the human bone marrow.
• Increased amount of proteins in the blood.
• Too little blood volume.
• Anemia of varying complexity and origin.
• Various diseases that cause the breakdown of red blood cells.
• Various infectious diseases.
• Renal failure.
• Various liver problems.

Prolonged bed rest can also cause a drop in the indicator in question. Insufficient level of physical activity is compensated proper diet. When conducting a blood test, attention is often paid to how the hematocrit level correlates with hemoglobin. A false result can be obtained in case of incorrect blood sampling.

Anemia

Anemia can develop in infants and children of other ages. The features of such a problem are the following:

• Anemia means that hemoglobin is below normal. This moment causes a significant decrease in the number of red blood cells in the blood.
• Hemoglobin is an important iron-containing protein, which means it is responsible for transporting oxygen to body tissues.

There are many reasons for such a problem. Symptoms may include dry and pale skin, lack of sufficient protein causes the digestive system to malfunction.

Hyperhydration

The hematocrit in the blood is also lowered in case of an excess amount of water, which may be contained in the whole body or in separate parts. Overhydration is associated with the following symptoms:

• Clinical symptoms are swelling of the extremities, excessive accumulation of fluid in the abdominal cavity.
• Some conditions with a similar condition can threaten the life of the child. The disease in question causes a violation heart rate, disorders of the digestive system.

A blood test for hematocrit is another important indicator by which doctors determine the state of health of the child and the presence of disease processes in him. The study helps to identify a deviation from the norm of the ratio of red blood cells to the amount of plasma in the direction of increasing or decreasing. Minor fluctuations are considered acceptable, but if the balance is significantly disturbed, the doctor, based on the indicators, diagnoses a certain disease.

In addition to standard tests, the level of red blood cells in the child is checked, which makes it possible to diagnose diseases.

How is a hematocrit test done?

To calculate the hematocrit number, the blood taken from a child is sent to a special test tube with divisions applied to its wall, inserted into a centrifuge and processed for one and a half hours. The centrifugation process allows you to separate the red blood cells from the plasma: heavy elements, including red blood cells, sink to the bottom of the vessel, and the plasma remains at the top.

Visually, the ratio of erythrocytes to plasma is determined by a scale on a test tube. Hematology analyzers are used to accurately calculate hematocrit. The resulting Ht indicator expresses the number of erythrocytes, without giving them an assessment of their quality, but such information is enough for physicians to make an accurate diagnosis. Express the value of Ht as a percentage, and write it as a fraction - liter / liter.

Age norms of hematocrit in children

A general blood test gives the level of hemoglobin, hematocrit and other blood characteristics (we recommend reading:). When evaluating the numerical value of erythrocytes, in order to establish a lowered or increased hematocrit, doctors start from their standard indicator, characteristic of a healthy newborn. In addition, doctors have deduced the norm for each age period of childhood, from birth to adulthood.

The results of a hematocrit blood test differ depending on the age of the child.

For clarity, we have combined all the numerical indicators of the norm into a separate table that looks like this:

What does deviation from the norm look like?

Experts consider deviations from the norm in the form of a decrease or increase as a sign of a painful pathology or physiological characteristics of the child. High Ht indicates an increased number of formed elements that make the blood viscous and thick. The presence of blood in this state provokes the formation of blood clots. However, an excess of the norm by 10-12% in infants and children up to a year is referred to as a physiological factor that does not cause concern. The picture looks alarming if the hematocrit is increased in a baby after a year.

The hematocrit is lowered - this means that the volume of blood cells has decreased, and they are responsible for the supply nutrients and oxygen to the organs. There is a violation of the acid-base balance, leading to oxygen starvation of cells, which negatively affects general condition baby. Weakness is manifested, the heartbeat quickens, the skin becomes pale, shortness of breath is present.

Why does hematocrit rise?

A marked increase in Ht is directly related to overproduction in the bone marrow (an increase in the number or size of red blood cells). The reason for the increased concentration of cells lies in the area pathological changes occurring in the body of a small patient. However, the process does not always occur due to pathological disorders in the body.

The hematocrit will be higher than normal if, before taking the test, the patient did not drink or his body was dehydrated as a result of vomiting or high fever.

Key boost factors

We will get a mandatory increase in Ht during painful processes that affect the growth in the number and size of erythrocytes. The main factors of high hematocrit in children can be:

1. True and redistributive erythrocytosis.
2. Excessive reproduction of red blood cells or erythremia (Wakez's disease, polycythemia). Manifested by uncomfortable tingling in the fingers and toes, heaviness in the head, sudden reddening of the skin, cardialgia. Similar symptoms accompany diseases that cause an increase in the size of red blood cells.
3. Compensatory response of the cardiovascular system to certain factors: pulmonary insufficiency, being at high altitude, kidney pathology, "blue" heart defects.

Relative causes

Incoming processes can provoke an increase in the Ht level. Doctors refer to them:

• frequent bouts of vomiting;
• diarrhea of ​​a profuse nature, causing thickening of the blood;
• bowel obstruction, in which fluid moves into it;
• increased sweating (hyperhidrosis);
• peritonitis;
• hereditary and acquired kidney disease;
• pathology formed in the respiratory organs;
• leukemia (more in the article:);
• burns and injuries;
• erythremia;
• asymptomatic oxygen starvation;
• long-term use of certain drugs (for example, glucocorticosteroids).

What affects the decrease in Ht?

A decrease in hematocrit is recorded when its level is clearly low, that is, it drops to 25%. Having found that the hematocrit is reduced, the doctor prescribes an additional examination to the small patient to find out the cause.

As a rule, a decrease in Ht is a consequence of the accumulation of an excess amount of fluid, due to which blood thins and the percentage of red blood cells and plasma changes (hyperhydration), and hemoglobin also decreases (see also:). The cause may be hyperproteinemia (excessive concentration of proteins). These changes are caused by:

1. Severe blood loss.
2. Violation of the formation of red blood cells in the bone marrow in the direction of reducing their number or size.
3. Hereditary or acquired hemolytic anemia, typhoid fever, malaria, hemolytic poisons, in which there is a rapid destruction of red blood cells.
4. Intravenous administration of a large amount of fluid for violations of renal function, leading to an increase in blood volume.
5. various types of anemia.
6. Hyperhydration - blood thinning due to disorders in the excretory system, insufficient blood circulation, water intoxication.
7. An increase in the level of protein in the blood (hyperproteinemia). Occurs with frequent vomiting acute infections, diarrhea, paraproteinemic hemoblastosis, Hodgkin's lymphoma, myeloma.

Anemia is a common cause of low hematocrit. The child needs the supervision of a doctor, the establishment of the correct diet. The doctor may suggest taking medications that increase Ht.

The baby's menu is made up of foods rich in iron: liver, apples, nuts, eggs, meat. It is useful for a child to take a hematogen sold in all pharmacies. Parents should ensure that all settings recommended by the pediatrician are observed.

Why is a false result of the analysis possible?

Some factors that occur at the time of blood sampling can distort the result of the analysis, showing an increase or decrease in hematocrit. For example, if blood sampling is done after severe blood loss, or before it, an intravenous infusion of a drug that thins the blood was performed. A false indicator will also be obtained when taking an analysis from a child who has been lying down for a long time. The level of Ht will be lower even when the vein has been clamped with a tourniquet for a long time. If the doctor has doubts, a second test is prescribed.

It should also be taken into account that the hematocrit indicator does not serve as a basis for establishing a diagnosis, it only warns that there is a pathology in the child's body or there is a risk of developing any disease. The final verdict of the doctor is announced only after studying all the tests, and in the case of hematocrit, its relationship with the level of hemoglobin is taken into account. If a decrease or increase in hematocrit is detected, parents should conduct a thorough examination of the baby in order to start treatment on time.