Clinical significance of optimal red cell mass and plasma volume estimation methods
2004
BACKGROUND: The aim of this study was to present and compare the results
of proposed methods for optimal red cell mass and plasma volume (RCM&PV) estimation,
and their influence on the interpretation of obtained results. MATERIAL AND METHODS: In 120/280 patients with polycythaemia rubra vera,
subjected to RCM&PV determination with autologous erythrocytes in vitro labelled
with 51Cr-sodium chromate, optimal volumes were determined using:
1. traditional ml/kg of:
- the real body weight method (ml/kg RBW);
- the optimal body weight method (ml/kg OBW).
2. the body weight, height, and sex based method (Retzlaff's tables),
3. the method recommended by the International Council for Standardization in
Haematology (ICSH), based on body surface area. RESULTS: Different interpretation of the same results of 120 RCM&PV measurements
was registered in 48/120 patients (40%). The greatest disagreement existed between
ml/kg RBW and ml/kg OBW methods (in 39/120 subjects, 32.5%). In underweight patients
the ml/kg RBW method, and in overweight patients the ml/kg OBW method, offered
better agreement with ICSH&Retzlaff's methods. The ml/kg RBW method disagreed with ICSH&Retzlaff's methods and ml/kg OBW in 25% and 19.2% of patients respectively.
ICSH and Retzlaff's methods disagreed in 10/120 patients (8.3%). The ICSH method
yielded significantly lower optimal volumes than Retzlaff's. CONCLUSION: Three methods for optimal RCM&PV estimation lead to different
interpretations of the same results of RCM&PV measurements with 51 Cr-erythrocytes
in 40% of patients. Two ml/kg body weight methods show greater disagreement in
comparison with ICSH and Retzlaff's methods, which differ significantly. The ICSH method yields lower optimal values compared to Retzlaff's.
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