HEMOGLOBIN DETERMINATION
A routine test performed on practically every
patient is the hemoglobin determination. Hemoglobin
determination, or hemoglobinometry, is
the measurement of the concentration of
hemoglobin in the blood. Hemoglobin's
main function in the body is to carry
oxygen from the lungs to the tissues and to
assist in transporting carbon dioxide from the tissues to
the lungs. The formation of hemoglobin takes
place in the developing red cells
located in bone marrow.
Hemoglobin values are affected by age, sex,
pregnancy, disease, and altitude. During pregnancy,
gains in body fluids cause the red cells to
become less concentrated, causing the
red cell count to fall. Since
hemoglobin is contained in red cells, the hemoglobin
concentration also falls. Disease may also
affect the values of hemoglobin. For
example, iron deficiency anemia may
drop hemoglobin values from a normal
value of 14 grams per 100 milliliters to 7 grams per 100
milliliters. Above-normal hemoglobin values
may occur when dehydration develops.
Changes in altitude affect the oxygen
content of the air and, therefore, also
affect hemoglobin values. At higher altitudes there is
less oxygen in the air, resulting in an
increase in red cell counts and
hemoglobin values. At lower altitudes
there is more oxygen, resulting in a decrease in red cell
counts and hemoglobin values.
Methods for hemoglobin determination are many
and varied. The most widely used automated method is
the cyanmethemoglobin method. To
perform this method, blood is mixed
with Drabkin's solution, a solution
that contains ferricyanide and cyanide. The
ferricyanide oxidizes the iron in the hemoglobin,
thereby changing hemoglobin to
methemoglobin. Methemoglobin then
unites with the cyanide to form
cyanmethemoglobin. Cyanmethemoglobin produces a
color which is measured in a
colorimeter, spectrophotometer, or
automated instrument. The color relates
to the concentration of hemoglobin in the blood.
Manual methods for determining blood hemoglobin
include the Haden-Hausse and Sahli-Hellige methods.
In both methods, blood is mixed with
dilute hydrochloric acid. This process
hemolyzes the red cells, disrupting the
integrity of the red cells' membrane and causing the
release of hemoglobin, which, in turn, is
converted to a brownish-colored
solution of acid hematin. The acid
hematin solution is then compared with a color standard.
Cyanmethemoglobim method
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