Hematocrit in newborns is low. What does high and low hematocrit mean in children? Hematocrit in children

We understand what it means if the hematocrit is lowered in the blood of a child, and when this indicator should be measured.

The composition of the blood and the amount of formed elements react to the influence of external and internal factors. Even minor pathological disorders lead to changes in laboratory blood parameters.

Measurement of the hematocrit value will allow diagnosing anemia at an early stage, when the disease does not manifest itself in the form of clinical symptoms. A decrease in the indicator will also indicate an increase in the level of total protein or overhydration.

The hematocrit value in medicine is determined by two concepts:

  • the total volume of erythrocytes in blood plasma;
  • the ratio of the total volume of all blood cells to the total volume of blood.

It should be noted that the equivalent application of these two concepts is acceptable, since 99% of the total number of blood cells falls directly on erythrocytes. It is known that up to 48% of the blood is cells (leukocytes, erythrocytes, platelets), and 65% is plasma.

The method for determining the indicator is simple: the collected venous blood is placed in a special measuring tube with graduation. The tube with biomaterial is centrifuged. As a result, the formed elements are deposited, the plasma is on top. The total volume of precipitated elements is an indicator of hematocrit.

Currently, the process is automated and devoid of large errors due to the subjective assessment of the laboratory assistant. However, the risk of obtaining inaccurate results is not excluded. This is possible at the stage of taking the biomaterial. If the baby's vein was tied with a tourniquet for a long time or hemolysis (destruction of red blood cells) occurred in the test tube, then the obtained indicators are unreliable. Biomaterial should be taken again.

A re-examination is also necessary if results are obtained that slightly deviate from the norm or are at the lower limit of the norm. It is necessary to understand exactly whether such a deviation was the result of the influence of temporary external factors or a sign of a disease.

When should hematocrit be checked?

The hematocrit value is not determined separately from other indicators of the general blood test. Since these data are not enough even for a screening examination. The value of hematocrit is important to consider when anemia is suspected, when assessing the degree of dehydration, when assessing the severity of hypoxia, when kidney diseases (polycystic, hydronephrosis, neoplasms), when an increased amount of proteins in the blood is suspected, as well as when there is an excess water content in the child's body.

The norm of hematocrit in children

A general blood test is taken from the baby in the first days of life after birth. This is necessary to assess the health of the newborn. The hematocrit value up to 14 days normally varies from 40 to 65%. Then it starts to gradually decrease.

In the first month it is 30 - 55%. In the second month from 27 to 43%. At 3 months, the maximum values ​​can normally reach 44%.

From 3 to 6 months, the reference values ​​​​of the value in question should be in the range from 30 to 41%. From six months to 1 year, the norm is from 33 to 43%.

Starting from 1 year and up to 12 years of age, the permissible hematocrit value is 30 - 42%. At the time of the onset of puberty, large-scale changes occur in the body of a teenager. The hormonal background and many laboratory parameters, including hematocrit, change. The norm for girls from 12 to 15 years old is from 34 to 41%, for boys - 37 - 45%. From 15 to 18 years of age, reference hematocrit values ​​are 31-44% and 38-49% for girls and boys, respectively.

What does it mean if the hematocrit is low in a child's blood?

Important: in newborn babies, a moderate decrease in hematocrit is a variant of the physiological norm. Therefore, it is fundamentally important to take into account the age of a small patient when deciphering the results of the analysis.

Anemia

A consistently low hematocrit in a child is a common sign of anemia. The disease is a group of similar clinical and hematological syndromes, united according to the principle of common manifestations:

  • a decrease in the concentration of hemoglobin in the blood in humans;
  • a combined decrease in the level of erythrocytes, which is accompanied by a regular drop in the hematocrit value.

The etiology of the disease is different. The main reasons include:

  • malnutrition, which is dominated by lactic acid products,
  • deficiency of vitamins and disturbed diet (rare meals).

A mild form of anemia may be accompanied by the child's weakness and increased fatigue, children begin to study worse due to a decrease in concentration. A more pronounced form is characterized by the manifestation in children of shortness of breath, frequent headaches, insomnia and decreased appetite. As a rule, children with anemia have pale skin and mucous membranes. Dry skin, yellowish-gray complexion, drowsiness, irritability, hair loss, brittle nails, desire to eat chalk, earth, etc. are also often noted.

Therapy of the disease directly depends on the etiology and is selected strictly by the attending physician. If necessary, iron and vitamin B12 preparations are selected for the child. It is important to review the diet by adding foods rich in iron and vitamins. Severe stages of the disease require a red blood cell transfusion.

infections

In children, infections of various etiologies and helminthic infestations can also become causes.

The peculiarity of the disease in a long course without the manifestation of clinical symptoms. It is detected in children during routine medical examinations, so it is so important not to miss them.

Hyperproteinemia

A decrease in hematocrit is characteristic of a state of hyperproteinemia, when the level of proteins in the body increases significantly. In this case, you should undergo additional diagnostics to clarify the causes. Possible causes include multiple myeloma, hyperglobulinemia purpura, and macroglobulinemia. A similar condition is also observed during intoxication of the body, when the kidneys are not able to fully detoxify harmful substances.

Fluid balance and kidney failure

If the water-salt metabolism is disturbed, the child begins to accumulate excess fluid in the body. What causes an increase in plasma volumes with unchanged levels of blood cells. This leads to a decrease in the hematocrit value. Symptoms: increased swelling of the limbs and organs (brain, lungs), abdominal dropsy.

Renal failure leads to a violation of the composition of the extracellular fluid secretion. Which enhances the breakdown of proteins, fats and carbohydrates. At the same time, decay products, entering the cells, cause significant humoral changes.

Is it dangerous that the hematocrit is low in a child? A decrease in the hematocrit level is dangerous because the child's body does not receive enough oxygen and develops worse. Any deviation in the analyzes from the norm always causes panic in parents and the search for the best doctor who will help to cope with the disease immediately begins. But in most cases, panic is unreasonable, and a low hematocrit (Ht) is very easy to correct. But what is Ht and how to suspect its decrease in time?

What is this indicator

Erythrocytes play an important role in the growth and development of the child's body, because thanks to these red blood cells, oxygen is transported, which is necessary for the growth and full functioning of all body tissues.

The hematocrit index determines the percentage of erythrocyte ratio of red blood cells to the volume of total blood flow in children.

The baby grows, and the norms change depending on age:

  • after birth 44-62%;
  • 0-3 months 32-44%;
  • 3-12 months 36-44%;
  • 1-10 years 37-44%.

Boys and girls under 10 years of age have almost the same hematocrit level, but older children are already adjusted for gender when taking an analysis.

From 10 to 17 years old, the norm should be:

  • boys - 35-34%;
  • girls - 34-44%.

The lower percentage of red blood cells in girls is due to the fact that they are going through puberty and the menstrual cycle is established.

Parents of girls whose menstrual cycle has not yet been established and Ht is slightly reduced, of course, need to show the child's doctor, but you should not panic - almost always a decrease in the percentage is associated with an unsteady menstrual cycle. If the cause is maturation, then no treatment is required, you just need to carefully monitor the girl's health.

What causes a drop in hematocrit

Why can a child's hematocrit be low? There are many reasons for this.

The most common provoking factors can be identified:

  • violation of the production of red blood cells in the germ of the bone marrow;
  • malfunctions of the spleen, where erythrocyte decay occurs;
  • high levels of protein fractions in the blood;
  • blood clotting disorder;
  • blood loss;
  • anemia;
  • an increase in the volume of circulating blood (with a delay in the removal of fluid from the body).

The most common cause of a decrease in the percentage of erythrocyte index is anemia. Most anemias, if the rate is reduced to 25%, respond well to treatment with a special diet and medication. The best drug for treatment is a pharmacy hematogen, which children eat with pleasure.

If the deviations from the norm are small, then, most likely, they are not caused by childhood pathologies, but by unfavorable external factors (malnutrition, heavy menstruation in teenage girls, or frequent colds). Such children are monitored by a pediatrician, and, if possible, the causes are eliminated. Treatment is prescribed only if the condition worsens.

At-risk groups

The hematocrit in a child is almost always at the same level and changes slightly only with age, in the process of growth of the child's body. But there are groups of children in whom the hematocrit number can change pathologically. Pediatricians refer such children to the risk group, and they are registered at the dispensary.

The risk group includes:

  1. Newborns born with a large body weight, and infants who are gaining weight pathologically quickly.
  2. Children who are malnourished or suffer from metabolic disorders.
  3. Children with a tendency to develop iron deficiency anemia.
  4. Newborns with congenital abnormalities in the work of the liver and kidneys.

These children should be closely monitored and all precipitating factors excluded. If it is possible to cure the underlying disease, then the erythrocyte composition will soon stabilize without specific treatment.

Is low hematocrit dangerous? Regardless of the cause that caused it, this condition is dangerous because it causes a violation of the supply of oxygen to the cells of the child's body. If this condition persists for a long time, it will negatively affect the growth and development of children.

It is important for every parent to know that everything is in order with the health of his child and there are no deviations from the norm. Quite often, these deviations can be determined by blood tests. That is why it is important to know when the hematocrit is low, which means that there are certain health problems that need to be addressed urgently. What does it mean? What measures should be taken, the causes and other features of this phenomenon - we will answer all these questions further.

Perhaps our articles will also be useful to you: “Hematocrit: what level is considered normal? Table by age "and" Hematocrit is lowered during pregnancy: norms for trimesters, causes of deviations.

Major deviations from the norm

It should be understood that if the hematocrit is elevated in a child, then this is the same problem as if such an indicator is reduced, therefore, appropriate measures should be taken to solve the problem.

  • Indicators can increase for several main reasons: dehydration, blood diseases, lack of oxygen in the body, kidney disease, getting burned, general intoxication of the body.
  • Reduced hematocrit in a child occurs most often in such situations: impaired bone marrow function, leukocytosis, internal bleeding, diseases of the hematopoietic system, anemia.

All these pathologies, diseases that reduce or increase the level of HCT in the blood are extremely dangerous for any child, so you should immediately seek medical help in order to undergo high-quality treatment.

Symptoms of low hematocrit

A decrease in hematocrit in children can cause various health problems. In this case, the following symptoms are observed:

  • The presence of a large number of toxins in the body.
  • General weakness, rapid fatigue.
  • Cardiopalmus.
  • Dizziness, feeling of nausea.

These are common symptoms of reduced hematocrit in children, but at the same time, many other unpleasant signs can be noticed, depending on the disease.

Is it always dangerous for a child?

Scientific studies show that small deviations from the normal hematocrit are not always dangerous for children. For example, the indicators may increase due to the fact that the child drank a small amount of water per day or he lives in a mountainous area where there is little oxygen in the air, and therefore there are a lot of red blood cells in the blood to compensate for a slight “oxygen starvation”.

A reduced or increased hematocrit in a child is always a definite challenge for parents, because they should not panic in any way, but in no case should they hesitate. If the value is constantly changing or, conversely, is very different from the norm, you should consult a pediatrician.

How to bring the indicators back to normal?

If the hematocrit is lowered or increased, then you should definitely pay attention to this. First of all, it is necessary to establish the exact cause of this or that deviation, to make a diagnosis of the disease.

Treatment consists in eliminating exactly the problem that caused the deviation from the norm. The following treatments are currently being used:

  • If anemia is the cause, you need to reconsider your own diet. It is recommended to eat more apples, nuts, lean meat, food should contain a large amount of iron.
  • The drug Hematogen. This is an excellent tool for improving the process of hematopoiesis, containing trace elements, nutrients and other beneficial substances.
  • Another important rule is to take liquid dosage forms of iron preparations for children, and do not give them double doses of such products, even if the previous dose of the medication was missed.

High levels of HCT in the blood of a child are also considered abnormal, and therefore are treated with fortified foods and drugs that normalize the level of red blood cells. Increased fluid intake is also prescribed.

Parents need to make sure that all indicators are normal, and the baby develops in accordance with his age, without experiencing any health problems.

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 occurs, the detection of elevated hematocrit in this case occurs during confirmation of 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. Most often, the cause in childhood, it occurs due to a violation 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. The most effective treatment is 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 babies are fed cow's or goat's milk, which has a much higher protein content than 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!