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At least 55 records · Page 3Linked to original sources
PubMed1990

Effect of immune-mediated erythrocyte agglutination on analysis of canine blood using a multichannel blood cell counting system.

Blood from six dogs with in vitro immune-mediated erythrocyte agglutination resulted in analytical errors in directly measured counting and sizing functions on a multichannel blood analysis system with histogram capability. Errors in the directly measured values, mean cell volume (MCV), and erythrocyte count were attributed to agglutinated erythrocyte particles that persisted during the relatively short reagent contact time of the analysis. Agglutinated particles less than 240 fl were visible on erythrocyte histograms and resulted in a false low erythrocyte count and false high MCV. Agglutinated cell particles greater than 240 fl were not present on the histogram scale. Because these latter particles exceeded the upper threshold, they did not influence determination of MCV, but resulted in a further decrease in the erythrocyte count. As a result, the other dependent erythrocyte indices were in error. These included false low hematocrit and false high mean corpuscular hemoglobin concentration (MCHC), when compared to corrected reference blood values. Similar errors occurred when analyzing blood samples that were agglutinated in vitro by incubating erythrocytes with incompatible plasma. The counting and sizing errors observed with electronic counting techniques were eliminated or greatly reduced by incubating blood in cell counting diluent for 10 minutes followed by analysis on a single channel counter with attached particle size analyzer. Error in erythrocyte measurement on a multichannel system may be anticipated if there is overt erythrocyte agglutination in a blood sample, an abnormally high MCHC is reported by the system, or subpopulations of large volume (agglutinated cells) are observed on a volume distribution histogram.

Journal Article↗
PubMed1993

Recommendations of the International Council for Standardization in Haematology for Ethylenediaminetetraacetic Acid Anticoagulation of Blood for Blood Cell Counting and Sizing. International Council for Standardization in Haematology: Expert Panel on Cytometry.

Of the three ethylenediaminetetraacetic acid (EDTA) salts used for anticoagulation of blood specimens for hematologic testing, potassium salts are the most readily soluble. Tripotassium EDTA is dispensed as a liquid and thus causes a slight dilution of the specimen. This salt also has been shown to affect the red blood cell size more at increased concentrations and on storage than the dipotassium salt. Therefore, dipotassium EDTA is recommended as the anticoagulant of choice in specimen collection for blood cell counting and sizing. The amount of dipotassium EDTA used is 1.5-2.2 mg (3.7-5.4 mumol) per milliliter of blood.

Anticoagulants↗
PubMed1999

Neonatal nucleated red blood cell counts in growth-restricted fetuses: relationship to arterial and venous Doppler studies.

OBJECTIVE: Elevated nucleated red blood cell count in neonatal blood and Doppler-detected circulatory decompensation in fetuses with intrauterine growth restriction are associated with hypoxemia. We sought to determine the relationship between the nucleated red blood cell count at birth and the circulatory status of fetuses with intrauterine growth restriction. STUDY DESIGN: Eighty-four fetuses with elevated umbilical artery pulsatility index values >2 SD above the gestational age mean and a subsequent birth weight <10th percentile were examined serially. Umbilical and middle cerebral artery pulsatility index, inferior vena cava and ductus venosus peak velocity index, and flow pattern in the umbilical vein (umbilical vein constant vs pulsatile) were recorded. Fetuses were grouped as follows, on the basis of the last examination before delivery: 1, elevated umbilical artery pulsatility index only; 2, middle cerebral artery pulsatility index >2 SD below the gestational age mean in addition to abnormal umbilical artery pulsatility index; 3, either peak velocity index >2 SD above the gestational age mean in the inferior vena cava and ductus venosus or pulsatile flow in the umbilical vein, or both. Nucleated red blood cells per 100 white blood cells were ascertained in a peripheral blood sample obtained within 1 hour of delivery with daily follow-up samples until the nucleated red blood cell count was <5/100 white blood cells. RESULTS: Groups 2 (median 38.5, range 1-273) and 3 (median 145, range 2-3180) had higher nucleated red blood cell counts than group 1 (median 8.5, range 1-270) (P <.05 and P <.005, respectively). The persistence of the nucleated red blood cell count elevation was also longer in groups 3 (median 4 days, range 1-19 days) and 2 (median 2. 5 days, range 1-7 days) than in group 1 (median 1 day, range 1-8 days). Neonates in group 3 also had lower platelet count, hemoglobin value, hematocrit value, and white blood cell count. The umbilical cord artery bicarbonate level was the strongest independent determinant of the peak nucleated red blood cell count and persistence of nucleated red blood cell elevation (r (2) = 0.27, P <. 001 and r (2) = 0.47, P <.0001). CONCLUSION: Increasing abnormality of arterial and venous flows in fetuses with intrauterine growth restriction is associated with increasing nucleated red blood cell count at birth. Metabolic acidemia rather than altered PO (2 ) associated with this circulatory state appears to be the main determinant of the rise in nucleated red blood cells.

Adult↗
PubMed2005

How to interpret and pursue an abnormal complete blood cell count in adults.

A complete blood cell count (CBC) is one of the most common laboratory tests in medicine. For example, at our institution alone, approximately 1800 CBCs are ordered every day, and 10% to 20% of results are reported as abnormal. Therefore, it is in every clinician's interest to have some understanding of the specific test basics as well as a structured action plan when confronted with abnormal CBC results. In this article, we provide practical diagnostic algorithms that address frequently encountered conditions associated with CBC abnormalities including anemia, thrombocytopenia, leukopenia, polycythemia, thrombocytosis, and leukocytosis. The objective is to help the nonhematologist recognize when a subspecialty consultation is reasonable and when it may be circumvented, thus allowing a cost-effective and intellectually rewarding practice.

Adult↗
PubMed1976

Combined blood cell counting and classification with fluorochrome stains and flow instrumentation.

A multiparameter flow cytophotometer was used to count and classify fixed human blood cells fluorochromed with a mixture of ethidium bromide (EB), brilliant sulfaflavine and a blue fluorescent stilbene disulfonic acid derivative (LN). The system measures light scattered by the cells and absorption at 420 nm for all cells. In addition, nuclear EB fluorescence (540 leads to 610 nm) and cytoplasmic fluorescence from LN (366 leads to 470 nm), brilliant sulfaflavine (420 leads to 520 nm) and EB exicted by energy transfer from LN (366 leads to 610 nm) are measured for all nucleated cells. This information is sufficient to perform red and white blood cell counts and to classify leukocytes as lymphocytes, monocytes, basophils, eosinophils or neutrophils. Light scattering and/or nuclear and cytoplasmic fluorescence values may be further analyzed to obtain the ratio of immature to mature neutrophils. Counts produced by the system are in reasonable agreement with those obtained by electronic cells counting and examination of Wright's-stained blood smears; some discrepancies appear to be due to systematic errors in the manual counting method.

Autoanalysis↗
PubMed1999

[Accuracy, precision and clinically acceptable level of complete blood cell count by an automated multichannel hematology analyzer].

Measurement of complete blood cell count (CBC) is one of the essential laboratory tests. In this study, the accuracy of CBC was high, when measured by six different automated blood cell counters, including SE-9000/RAM-1, CELL-DYN 4000, ADVIA 120, VEGA RETIC-LC141 or GEN*S. The correlations of CBC counts among these instruments were also good. In contrast, the accuracy in abnormal samples depended on matching the instrument and type of clinical conditions. Internal quality control of automated multichannel hematology analyzers was recommended by the NCCLS H26-A in 1996. However, actual external quality control of the CBC count was poorly understood. We surveyed three samples from healthy volunteers for CBC values in 1997. Among six different instruments, the inter-assay of the red blood cell count (RBC), hemoglobin, hematocrit and MCV was fairly good, shown as < 4.2%, < 3.0%, < 4.4% and < 3.4%, respectively. In contrast, the inter-assay of the white blood cell count (WBC) and platelet (PLT) was not good, shown as < 11.4% and < 9.6%, respectively. The clinically acceptable levels for the blood cell count were reported to be 4% for RBC, 3% for hemoglobin, 4% for MCV, 5% for WBC and 7% for PLT, by JCCLS in 1994. The clinically acceptable CBC by hematologists at Keio University resembled those by councilors of The Japanese Society of Clinical Hematology, whereas, residents at Keio University and general physicians required more precise clinical CBC counts. These results indicate that a larger study is needed to clarify the accuracy, clinically acceptable level, and performance of different automated blood cell counters.

Blood Cell Count↗
PubMed1992

Accuracy and utility of differential white blood cell count in the neonatal intensive care unit.

The clinical utility of the complete blood cell count (including the differential white blood cell count) as a means to follow the course of infants in a neonatal intensive care unit was assessed. Utility was judged for three purposes: (1) predicting the onset of clinically unrecognized disease, (2) assessing the severity of current disease, and (3) following a trend during treatment. Neither conventional nor automated differential counts were useful for surveillance (predicting the onset of clinically unrecognized disease). The white blood cell count, the platelet count, and the absolute immature neutrophil count and immature/total neutrophil ratio were useful to assess the severity of current clinical events. The white blood cell count was superior to the differential count for following trends in patients' conditions. Information regarding nuclear immaturity derived from automated counts and the cost and slowness of the manual differential count are good indications for decreased use of conventional counts, increased use of certain features of the automated differential, or both, in neonatal intensive care units.

Automation↗
PubMed2001

Fetal nucleated red blood cell counts in peripheral blood of mothers bearing Down syndrome fetus.

Currently, prenatal detection of Down syndrome and other most common aneuploidies relies on invasive procedures such as amniocentesis and villocentesis, and on non-invasive screening tests such as second trimester maternal serum screening (Triple test), and first trimester screening (ULTRA-screen). However, it well known that invasive techniques carry a small risk of fetal loss, while both Triple test and ULTRA-screen are not diagnostic, may miss from 15 - 40 % of cases of Down syndrome, in addition to having a 5 - 8 % rate of false-positives. We now report clear evidence that the number of fetal nucleated red blood cells (FNRBCs) in the maternal circulation is remarkably higher in pregnant women carrying aneuploid fetuses, especially in cases of Down syndrome. These results are in agreement with the findings of other investigators using different methods, and suggest that the number of FNRBCs present in the maternal blood sample could be used as additional marker, in concert with existing screening tests, to improve non-invasive detection of Down syndrome, and other most common aneuploidies.

Adult↗
PubMed2006

Are placental chorionic capillary nucleated red blood cell counts useful compared to umbilical cord blood tests?

OBJECTIVE: To compare measurement of fetal nucleated red blood cell (NRBC) counts in paired histologic samples of the placenta and umbilical cord bloods. METHOD: Forty-five randomly selected pregnancies had two determinations of the NRBC count. A sample of umbilical venous blood had a NRBC count measured and sections of the placenta were examined for their villous capillary NRBC counts. RESULTS: Umbilical venous blood had NRBC/100 white blood cell counts ranging from 0 to 67. Paired evaluation of placental tissue had NRBC counts of 0-5 with 60% being zero compared to 8% zero counts in cord blood. There was no correlation between the paired counts (R(2) = 0.04). CONCLUSION: Umbilical cord blood provides different information on fetal NRBC count than does histologic study of the placenta.

Adult↗
PubMed1994

[JCCLS proposal for clinical allowance on values of blood cell count].

We investigated the clinically allowable error for laboratory quality control of blood cell count in Japan. We have asked 409 members of Japanese Association of Clinical Hematology for an appropriate clinical allowance on the values of red blood cell count (RBC), hemoglobin value (Hb), mean corpuscular volume (MCV), white blood cell count (WBC) and platelet count (PLT). We delivered the lists in which 5 different allowable errors (2, 3, 5, 10 and 20%) were indicated on each blood cell count so that each member could check one of them. The data were collected within a month and were analyzed with computer. The results showed that 312 (76.3%) members choose 3 or 5% as an allowable error for RBC, 393 (96.1%) selected 2, 3 or 5% for Hb, 314 (76.8%) choose 3 or 5% for MCV, 358 (77.5%) indicated 3, 5 or 10% for WBC and 294 (72.6%) selected 5 or 10% for PLT. Based on these data, we propose the following clinical allowances for the values of blood cell count; 4% for RBC, 3% for Hb, 4% for MCV, 5% for WBC and 7% for PLT.

Blood Cell Count↗