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Hemoglobin: Key Facts & Reference Values

Learn about hemoglobin, its role in the body, detection methods, reference values, and factors affecting levels. Understand how to interpret hemoglobin tests accurately.

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Hemoglobin: Key Facts & Reference Values

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  1. Hemoglobin Determination

  2. Hemoglobin • Hemoglobin • Found in the RBC. • Responsible for carrying oxygen to all cells in the body. • Also binds to carbon dioxide and carries it to the lungs from the cells to be released. • An accurate measurement of hemoglobin in the body gives the health care worker an idea of the patient’s oxygen carrying capacity. • Hemoglobin detection can also give the health care worker of current blood loss and recovery from blood loss. • Monitoring hemoglobin can also aid in the treatment of RBC disorders, like anemia.

  3. Hemoglobin • Hemoglobin • Makes up 98% of the protein found in the RBC. • Gives blood its red color. • Composed of two parts…. • Heme 4 iron atoms in the ferrous state (Fe2+) • Globin  4 protein chains (genetically determined) • The most common globin forms are alpha and beta chains. • Hemoglobin's are named based on the structure of the protein chain that is present. • Hemoglobin A  95-98% of adult hemoglobin • Hemoglobin A2  3-5% of adult hemoglobin • Hemoglobin F  normal fetal hemoglobin, <1% of adult hemoglobin • Hemoglobin S  abnormal hemoglobin found in sickle cell anemia

  4. Hemoglobin • Each hemoglobin molecule contains four heme groups (iron molecules), each associated with its own protein chain. • Iron is a must for hemoglobin synthesis. • Iron is reused by the body as needed. • When old RBCs die the iron is recycled to make new hemoglobin molecules. • If the body doesn’t have enough iron, hemoglobin production decreases and the RBCs will not have enough hemoglobin. • This can result in anemia causing patients to experience fatigue and paleness of skin. • Excessive blood loss can also lead to low iron levels and poor hemoglobin production.

  5. Reference Values for Hemoglobin • Reference values for hemoglobin depend on gender and age. • Hemoglobin is higher at birth and lowers with childhood and increases again as you get older. • At birth hemoglobin levels range from 16-23 g/dL • During childhood hemoglobin levels range from 10-14 g/dL • Adult males have hemoglobin levels ranging from 13-17 g/dL • Adult females have hemoglobin levels ranging from 12-16 g/dL • Your hemoglobin level should be 1/3 of your hematocrit level. • Exercise as well as diet affect the level of hemoglobin you have in your system. • If you exercise a lot your hemoglobin will be higher because you need more oxygen carrying capacity. • If you have a diet low in iron your hemoglobin level may be lower than normal.

  6. Reference Values for Hemoglobin • Determining hemoglobin value • There are several ways to determine a person’s hemoglobin concentration. • Methods include….. • Specific Gravity Technique • Cyanmethemoglobin • Azidemethemoglobin • Some methods can be performed manually while others are performed on a hematology or POCT analyzer.

  7. Reference Values for Hemoglobin • Determining hemoglobin value • Specific Gravity Technique • Estimates the hemoglobin concentration. • Drop of blood is placed into a cupper sulfate solution. • The specific gravity of the solution must be from 1.052 to 1.054. • This is the same specific gravity of blood with a hemoglobin concentration at the low end of the reference range. • If the drop falls to the bottom quickly the specific gravity is higher than the solution and the hemoglobin is in the normal range. • If the drop floats or falls slowly the specific gravity is lower than the solution and the hemoglobin is below the normal range. • Common method in blood donation centers like the American Red Cross.

  8. Reference Values for Hemoglobin • Determining hemoglobin value • Cyanmethemoglobin • Blood is mixed with a reagent (Drabkin’s reagent) containing iron, potassium, cyanide, and sodium bicarbonate. • The Drabkin’s reagent and the hemoglobin in the blood combin to form a colored end- product known as cyanmethemoglobin. • A hematology analyzer or hemoglobinometer measures the end product photometrically.

  9. Reference Values for Hemoglobin • Determining hemoglobin value • Azidemethemoglobin • The azidemethemolgobin reagent contains a lysing chemical, an oxidizing chemical and azide. • The oxyhemoglobin which is in the form of ferrous iron is oxidized to ferric iron to form methemoglobin. • The methemoglobin combines with azide to form azidemethemoglobin, that can also be measured photometrically by a hematology analyzer.

  10. Reference Values for Hemoglobin • Determining hemoglobin value • POCT analyzers or hematology analyzers use the before mentioned methods to determine one’s hemoglobin. • POCT analyzers require only a small drop or two of blood to determine the sample’s hemoglobin concentration. • Hematology analyzers require more blood and test for more parameters than the hemoglobin alone and often times run an entire CBC.

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