Determination of Hemoglobin Level Among 9-Month-Old Infants Visiting Well Child Clinic

Screening for anemia is recommended among infants aged 9 to 12 months. This study was conducted to determine the prevalence of anemia among 9-month-old infants at Well Child Clinic, and associated factors with anemia. Well Child record of all visits during January to December 2018 were reviewed. Hemoglobin (Hb) was determined by complete blood count (CBC) or point-of-care Hb (POC-Hb). Anemia was found in 99 from 145 infants (68.3%). The prevalence of anemia was 33.3% and 72.8% when tested by CBC and POC-Hb, respectively. Breastfed Infants had significantly lower mean Hb than formula-fed infants. The odd ratio [95% confident interval] of having anemia among infants who were fed with infant formula were 0.37 [0.14-0.94]; P = .038 when compared to breastfed infants. There was a high proportion of anemia among 9-month-old infants in Rama-WCC and breastfeeding was associated with anemia in infants. The use of POC-Hb may overestimate the prevalence of anemia.

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Prevalence of anemia in exclusively breastfed full term babies between 3-6 months of age

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20210117 ◽

2021 ◽

Vol 8 (2) ◽

pp. 300

Author(s):

Rajakumar Marol ◽

Renuka Marol

Keyword(s):

Breast Feeding ◽

Growth And Development ◽

Blood Count ◽

Iron Supplementation ◽

Complete Blood Count ◽

Cochrane Review ◽

Exclusive Breast Feeding ◽

Breastfed Infants ◽

Increased Risk ◽

Prevalence Of Anemia

Background: WHO recommends exclusive breast feeding for 6 months without examination for anemia. However there are concerns about the feasibility and safety of this recommendation. Cochrane review studies especially in developing countries, suggest that exclusive breastfeeding up to 6 months without iron supplementation may compromise the hematologic status of children leading to IDA and its consequences. So the question arises; does absolute breast feeding protect infants from anemia during first 6 months of life? The present study was conducted to estimate the prevalence of anemia in exclusively breastfed babies between 3-6 months of age.Methods: This was a retrospective study conducted between January 2019 and December 2019 at Shivajyoti Institute of Child Health-Haveri, in exclusively breastfed infants aged between 3-6 months who attended OPD and underwent complete blood count examination. Hemoglobin levels were collected and anemia was defined and classified as per WHO criteria for 6-24 months old children.Results: Out of 81 infants 52 were males and 29 were females. Age wise, 26 babies were 3 months, 34 were 4 months and 21 were 5 months old. A total of 71 children had anemia; 49 mild, 20 moderate and 2 severe. The prevalence of anemia was 87.6% and it was highest (92.3%) at 3 months of age.Conclusions: Exclusively breastfed infants between 3-6 months are at increased risk of anemia. Therefore infants after 3 months, should be evaluated for anemia and iron deficiency which is the commonest cause of anemia. Such infants should be supplemented with oral iron in addition to exclusive breast feeding for 6 months, to prevent adverse effects of IDA on infants’ growth and development.

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332: Can a point-of-care hemoglobin device replace complete blood count for fetal blood sampling during intrauterine transfusion?

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2017.10.268 ◽

2018 ◽

Vol 218 (1) ◽

pp. S207-S208

Author(s):

Cathy Monteith ◽

Jahan Jadauji ◽

Hala Abu ◽

Ann M. McHugh ◽

Jennifer C. Donnelly ◽

...

Keyword(s):

Blood Count ◽

Complete Blood Count ◽

Point Of Care ◽

Blood Sampling ◽

Fetal Blood ◽

Fetal Blood Sampling ◽

Intrauterine Transfusion

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Coagulopathy in Cardiac Surgery: Etiology and Treatment Options

Cardiothoracic Critical Care ◽

10.1093/med/9780190082482.003.0033 ◽

2020 ◽

pp. 313-322

Author(s):

Dana Teodorescu ◽

Caroline Larkin

Keyword(s):

Cardiac Surgery ◽

Laboratory Testing ◽

Blood Count ◽

Complete Blood Count ◽

Point Of Care ◽

Treatment Options ◽

Coagulation Factors ◽

Bleeding Diathesis ◽

Standard Laboratory ◽

Post Cardiac Surgery

This chapter reviews the causes and outlines an approach to the management of coagulopathy following cardiac surgery. Bleeding after cardiac surgery is common and expected up to a rate of 2 mL/kg/h for the first 6 hours. A more significant hemorrhage needs to be investigated and treated. Causes are often multifactorial. It is imperative that surgical causes be excluded early concomitant to providing resuscitation, investigating other medical causes for bleeding, and treating coagulopathy empirically until laboratory testing becomes available. The most frequent causes for coagulopathy post–cardiac surgery are excess heparinization, prolonged cardiopulmonary bypass time, hypothermia, acidosis, and preexisting bleeding diathesis. The management of coagulopathy implies maintenance of the normal physiological conditions for coagulation, reversal of excess heparinization, treatment of hyperfibrinolysis, maintaining normal levels of coagulation factors, and transfusion of platelets if thrombocytopenia or platelet dysfunction occurs. The chapter reviews what is involved in standard laboratory testing (complete blood count, prothrombin time, activated partial thromboplastin time, fibrinogen level, etc.) for coagulopathy. Also discussed is point-of-care testing and how the results from these tests should be interpreted. The chapter details the various blood products that are required in this scenario and suggests doses and transfusion thresholds.

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Comparison between blood hemoglobin concentration determined by point-of-care device and complete blood count in adult patients with dengue

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0009692 ◽

2021 ◽

Vol 15 (8) ◽

pp. e0009692

Author(s):

Kantasit Wisanuvej ◽

Kochawan Boonyawat ◽

Chutchaiwat Savetamornkul ◽

Sirapong Virapongsiri ◽

Jatupon Krongvorakul ◽

...

Keyword(s):

Blood Count ◽

Complete Blood Count ◽

Point Of Care ◽

Hemoglobin Concentration ◽

Warning Signs ◽

Adult Patients ◽

Severe Dengue ◽

University Hospitals ◽

Automated Method ◽

Indispensable Tool

Background Hematocrit measurement has been an indispensable tool for monitoring plasma leakage and bleeding in dengue patients. However, hematocrit measurement by automated methods is hampered by frequent venipunctures. Utility of point-of-care hemoglobin (POC-Hb) test for monitoring dengue patients has not been established. We evaluated the relationship between hemoglobin measured by POC-Hb testing and hematocrit measured by the automated method in adult dengue patients. Methodology and principal findings Adult dengue patients were recruited at two university hospitals in Thailand from October 2019 to December 2020. POC-Hb test was performed using capillary blood simultaneously with venipuncture to obtain whole blood for an automated complete blood count (CBC) analysis. The correlation of hemoglobin and hematocrit measurement was evaluated. A total of 44 dengue patients were enrolled. Twenty-nine patients (65.9%) were female, with a median age of 31 years (interquartile range 22–41). Of the enrolled patients, 30 (68.2%), 11 (25.0%), and 3 (6.8%) were classified as dengue without warning signs, with warning signs, and severe dengue, respectively. Seven patients (15.9%) had hemoconcentration, and five patients (11.3%) had bleeding. A total of 216 pairs of POC-Hb and CBC were evaluated. A significant positive correlation was observed between hemoglobin measured by POC-Hb testing and hematocrit measured by an automated CBC (r = 0.869, p <0.001). Bland-Altman analysis between hemoglobin measured by POC-Hb testing and an automated CBC showed a bias of -0.43 (95% limit of agreement of -1.81 and 0.95). Using the cutoff of POC-Hb ≥20% as a criteria for hemoconcentration, the sensitivity and specificity of hemoconcentration detected by POC-Hb device were 71.4% and 100.0%, respectively. Conclusions Hemoglobin measurement by POC-Hb testing has a strong correlation with hematocrit in adult patients with dengue fever. However, the sensitivity in detecting hemoconcentration is fair. The adjunct use of capillary POC-Hb testing can decrease the frequency of venipuncture. Further study in children is encouraged.

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Publisher Correction: A cartridge based Point-of-Care device for complete blood count

Scientific Reports ◽

10.1038/s41598-020-76738-3 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Usama Abbasi ◽

Prasanta Chowdhury ◽

Sasikala Subramaniam ◽

Prakhar Jain ◽

Nitin Muthe ◽

...

Keyword(s):

Blood Count ◽

Complete Blood Count ◽

Point Of Care

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

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Cetuximab and Anemia Prevention in Head and Neck Cancer Patients Undergoing Radiotherapy

Blood ◽

10.1182/blood-2020-138929 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 7-8

Author(s):

Lucas Maahs ◽

Ahmed Ghanem ◽

Amy Tang ◽

Swarn Arya ◽

Zaid Al Saheli ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Complete Blood Count ◽

Demographic Data ◽

Hemoglobin Level ◽

Head And Neck Cancers ◽

Guest Speaker ◽

Prevalence Of Anemia

Introduction: Anemia is a major complication of treatment and a frequent cause of morbidity in cancer patients. Radiation therapy (RT) induces an inflammatory response and increased levels of interleukin-6 (IL-6), potentially causing anemia of chronic inflammation or worsening of pre-existing anemia. Head and neck cancers often overexpress epidermal growth factor receptors (EGFR), which can also lead to increased IL-6 levels. Cetuximab, an EGFR inhibitor, has been previously associated with a decreased incidence of anemia when added to cytotoxic chemotherapy (Vermorken et al,N Engl J Med, 2008). One study has also reported significantly lower rates of anemia in patients that received cetuximab with RT compared to those that received RT alone (Bonner et al,N Engl J Med, 2006). We hypothesized that cetuximab could prevent RT-induced anemia, possibly by decreasing IL-6 levels as a result of EGFR blockade. Methods: After obtaining IRB approval, we queried our institutional head and neck cancers database for nonmetastatic squamous cell carcinomas diagnosed between 2006 and 2018 that were treated with adjuvant or definitive RT with or without concomitant Cetuximab. Demographic data and tumor characteristics were collected, as well as pre and post RT laboratory values. We only included patients who had at least one complete blood count in the 3 months preceding treatment and another one up to 4 months after treatment. The primary outcome was the prevalence of anemia after RT. Secondary outcomes included mean hemoglobin levels and improvement of hemoglobin levels after RT conclusion. Anemia was defined as a hemoglobin level lower than 12g/dL in females and 13g/dL in males. Improvement of hemoglobin levels was defined as resolution of anemia after treatment in patients with anemia at baseline or an increase of at least 1g/dL in the rest of the included patients. Results: A total of 171 patients were identified, 85 in the cetuximab plus RT group and 86 in the RT-only group. Demographic characteristics were well-balanced among study groups, except for the Charlson comorbidity index, which was higher in the RT-only group (p=0.04). Most patients were treated in a definitive setting (61.4%), and the remainder received treatment in the adjuvant setting (38.6%). The cetuximab group had more patients with advanced disease (75.3% vs. 40.7%, p<0.001) and worse clinical and radiologic response rates to treatment. All-cause mortality was higher in the group of patients that received cetuximab (69.4% vs. 46.5%, p=0.004). The prevalence of anemia before treatment was similar, but there were lower rates of anemia in the RT-only group after treatment (63.5% vs. 44.2%, p=0.017), with a mean hemoglobin level of 11.98g/dL vs. 12.9g/dL for cetuximab combine with RT vs. RT alone (p=0.003). There was no difference in the levels prior to treatment (12.20g/dL vs 12.48g/dL, p =0.39). There was no difference in the percentage of patients that had improvement of hemoglobin levels between groups, although the majority achieved an improvement (69.4% vs. 80.2%, p=0.14). The prevalence of chronic kidney disease, vitamin B12 deficiency, folate deficiency, iron deficiency and iron overload was similar between groups. The overall survival was not statistically different for patients that had improvement in hemoglobin levels compared to those who did not. Conclusion: Cetuximab was not associated with lower rates of anemia after RT for nonmetastatic head and neck cancer patients compared to RT alone. It is possible that the heterogeneity of the research population due to the retrospective nature of this study contributed to our findings. Prospective studies are needed to better assess the effect of Cetuximab in anemia during RT. Figure Disclosures Siddiqui: Varian Medical Systems:Other: Instructor for Varian Clinical School and guest speaker- receive honorarium.

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Reference Range of Complete Blood Count in Healthy Term Newborns 1 Week after Birth

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.7781 ◽

2021 ◽

Vol 9 (A) ◽

pp. 1565-1569

Author(s):

Harapan Parlindungan Ringoringo

Keyword(s):

Birth Weight ◽

Standard Deviation ◽

Blood Count ◽

Reference Range ◽

Complete Blood Count ◽

White Blood Count ◽

Inclusion Criteria ◽

Term Newborns ◽

Prospective Analyses

BACKGROUND: Determination of the complete blood count (CBC) and reticulocyte reference range helps diagnose a disease related to changes in erythrocyte indices, white blood count, platelets, and reticulocytes, especially in newborns. AIM: The aim study is to establish a reference range for CBC and reticulocyte in healthy term newborns 1 week after birth. MATERIAL AND METHODS: The study method is prospective analyses of CBC and reticulocyte in term newborns within 1 week after birth. Inclusion criteria are term newborn (gestational age 37–42 weeks) with good tone, breathing, or crying immediately, do not have resuscitation, and the birth weight is ≥2500 g. RESULTS: Two hundred and seventy-seven term newborns met the inclusion criteria. There were 145 (52.35%) male infants and 132 (47.65%) female infants. The reference range of newborns for hemoglobin (Hb) at P2.5–P97.5, P3–P97, P5–P95, and mean ± 2 standard deviation (SD) was 11.70–19.60 g/dL, 11.90–19.57 g/dL, 12.20–19.20 g/dL, and 11.35–19.63 g/dL, respectively. In addition, reference range of male newborns for Hb at P2.5–P97.5, P3–P97, P5–P95, and mean ± 2SD was 12.20–20.14 g/dL, 12.28–19.91 g/dL, 12.63–19.38 g/dL, and 11.47–20.15 g/dL, respectively. The reference range of female newborns for Hb at P2.5–P97.5, P3–P97, P5–P95, and mean ± 2 SD was 11.37–19.20 g/dL, 11.50–19.20 g/dL, 11.80–19.20 g/dL, and 11.37–18.93 g/dL, respectively. CONCLUSION: The reference range of CBC and reticulocyte for healthy term newborns, male newborns, and female newborns in this study can be used as a benchmark.

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