Blood volume

Last updated

Blood volume (volemia) is the volume of blood (blood cells and plasma) in the circulatory system of any individual.

Contents

Humans

A typical adult has a blood volume of approximately 5 liters, with females and males having approximately the same blood percentage by weight (approx 7 to 8%) [1] [2] Blood volume is regulated by the kidneys.

Blood volume (BV) can be calculated given the hematocrit (HC; the fraction of blood that is red blood cells) and plasma volume (PV), with the hematocrit being regulated via the blood oxygen content regulator:

Blood volume measurement may be used in people with congestive heart failure, chronic hypertension, kidney failure and critical care.

The use of relative blood volume changes during dialysis is of questionable utility. [3]

Total Blood Volume can be measured manually via the Dual Isotope or Dual Tracer Technique, a classic technique, available since the 1950s. [4] This technique requires double labeling of the blood; that is 2 injections and 2 standards (51Cr-RBC for tagging red blood cells and I-HAS for tagging plasma volume) as well as withdrawing and re-infusing patients with their own blood for blood volume analysis results. This method may take up to 6 hours for accurate results. The blood volume is 70 ml/kg body weight in adult males, 65 ml/kg in adult females and 70-75 ml/kg in children (1 year old and over). [5] [6]

Total Blood Volume has been measured manually by the use of carbon monoxide (CO) as a tracer for more than 100 years and was first proposed by French scientists Grehant and Quinquaud in 1882. Soon after a usable set-up for human use was developed by Oxford scientists John Haldane and Lorrain Smith and presented in the Journal of Physiology in 1900. [7]

Semi-automated system

Blood volume may also be measured semi-automatically. The BVA-100, a product of Daxor Corporation, is an FDA-cleared diagnostic used at leading medical centers in the United States which consists of an automated well counter interfaced with a computer. [8] It is able to report with 98% accuracy within 60 minutes the Total Blood Volume (TBV), Plasma Volume (PV) and Red Cell Volume (RCV) using the indicator dilution principle, microhematocrit centrifugation and the Ideal Height and Weight Method. [4] The indicator, or tracer, is an I-131 albumin injection. An equal amount of the tracer is injected into a known and unknown volume. Clinically, the unknown volume is the patient's blood volume, with the tracer having been injected into the patient's blood stream and tagged to the blood plasma. Once the tracer is injected a technician takes five blood samples which undergo microhematocrit centrifugation to extrapolate true blood volume at time 0. The concentration of the I-131 in the blood is determined from the blood radioactivity against the standard, which has a known I-131 dilution in a known volume. The unknown volume is inversely proportional to the concentration of the indicator in the known volume; the larger the unknown volume, the lower the tracer concentration, thus the unknown volume can be calculated. The microhematocrit data along with the I-131 indicator data provide a normalized hematocrit number, more accurate than hematocrit or peripheral hematocrit measurements. [9] Measurements are taken 5 times at 6-minute intervals so that the BVA-100 can calculate the albumin transudation time to understand the flux of liquid through capillary membranes.

Blood volumes can also been measured in humans using the non-radioactive, carbon monoxide (CO) rebreathing technique. The Detalo Clinical, a product of Detalo Health, is a CE-marked medical device used by leading hospitals in Europe. [10] With this technique, a small volume of pure CO gas is inhaled and rebreathed for a few minutes. During rebreathing, CO binds to hemoglobin present in red blood cells. Based on the increase in blood CO after the rebreathing period, the volume of blood can be determined through the dilution principle. The entire measurement takes less than 15 minutes and has a typical error of 1.5%. [11]

Other animals

AnimalBlood volume
(ml/kg) [12]
Cat 55 (47-66)
Cow 55 (52-57) [13]
Dog 86 (79-90)
Ferret 75
Gerbil 67
Goat 70
Guinea pig 75 (67-92)
Hamster 78
Horse 76
Human (male) 75
Human (female) 65
Monkey (rhesus) 54
Mouse 79 (78-80)
Pig 65
Rabbit 56 (44-70)
Rat 64 (50-70)
Sheep 60
Marmoset 60-70 [14]

The table at right shows circulating blood volumes, given as volume per kilogram, for healthy adults and some animals. [12] However, it can be 15% less in obese and old animals. [12]

See also

Related Research Articles

<span class="mw-page-title-main">Hemoglobin</span> Metalloprotein that binds with oxygen

Hemoglobin is a protein containing iron that facilitates the transportation of oxygen in red blood cells. Almost all vertebrates contain hemoglobin, with the sole exception of the fish family Channichthyidae. Hemoglobin in the blood carries oxygen from the respiratory organs to the other tissues of the body, where it releases the oxygen to enable aerobic respiration which powers an animal's metabolism. A healthy human has 12 to 20 grams of hemoglobin in every 100 mL of blood. Hemoglobin is a metalloprotein, a chromoprotein, and globulin.

Diffusing capacity of the lung (DL) measures the transfer of gas from air in the lung, to the red blood cells in lung blood vessels. It is part of a comprehensive series of pulmonary function tests to determine the overall ability of the lung to transport gas into and out of the blood. DL, especially DLCO, is reduced in certain diseases of the lung and heart. DLCO measurement has been standardized according to a position paper by a task force of the European Respiratory and American Thoracic Societies.

<span class="mw-page-title-main">Blood plasma</span> Liquid component of blood

Blood plasma is a light amber-colored liquid component of blood in which blood cells are absent, but which contains proteins and other constituents of whole blood in suspension. It makes up about 55% of the body's total blood volume. It is the intravascular part of extracellular fluid. It is mostly water, and contains important dissolved proteins, glucose, clotting factors, electrolytes, hormones, carbon dioxide, and oxygen. It plays a vital role in an intravascular osmotic effect that keeps electrolyte concentration balanced and protects the body from infection and other blood-related disorders.

<span class="mw-page-title-main">Complete blood count</span> Routine laboratory test of blood cells

A complete blood count (CBC), also known as a full blood count (FBC), is a set of medical laboratory tests that provide information about the cells in a person's blood. The CBC indicates the counts of white blood cells, red blood cells and platelets, the concentration of hemoglobin, and the hematocrit. The red blood cell indices, which indicate the average size and hemoglobin content of red blood cells, are also reported, and a white blood cell differential, which counts the different types of white blood cells, may be included.

<span class="mw-page-title-main">Cardiac output</span> Measurement of blood pumped by the heart

In cardiac physiology, cardiac output (CO), also known as heart output and often denoted by the symbols , , or , is the volumetric flow rate of the heart's pumping output: that is, the volume of blood being pumped by a single ventricle of the heart, per unit time. Cardiac output (CO) is the product of the heart rate (HR), i.e. the number of heartbeats per minute (bpm), and the stroke volume (SV), which is the volume of blood pumped from the left ventricle per beat; thus giving the formula:

Hemodynamics or haemodynamics are the dynamics of blood flow. The circulatory system is controlled by homeostatic mechanisms of autoregulation, just as hydraulic circuits are controlled by control systems. The hemodynamic response continuously monitors and adjusts to conditions in the body and its environment. Hemodynamics explains the physical laws that govern the flow of blood in the blood vessels.

In physiology, body water is the water content of an animal body that is contained in the tissues, the blood, the bones and elsewhere. The percentages of body water contained in various fluid compartments add up to total body water (TBW). This water makes up a significant fraction of the human body, both by weight and by volume. Ensuring the right amount of body water is part of fluid balance, an aspect of homeostasis.

<span class="mw-page-title-main">Hematocrit</span> Volume percentage of red blood cells in blood

The hematocrit, also known by several other names, is the volume percentage (vol%) of red blood cells (RBCs) in blood, measured as part of a blood test. The measurement depends on the number and size of red blood cells. It is normally 40.7–50.3% for males and 36.1–44.3% for females. It is a part of a person's complete blood count results, along with hemoglobin concentration, white blood cell count and platelet count.

Hemorheology, also spelled haemorheology, or blood rheology, is the study of flow properties of blood and its elements of plasma and cells. Proper tissue perfusion can occur only when blood's rheological properties are within certain levels. Alterations of these properties play significant roles in disease processes. Blood viscosity is determined by plasma viscosity, hematocrit and mechanical properties of red blood cells. Red blood cells have unique mechanical behavior, which can be discussed under the terms erythrocyte deformability and erythrocyte aggregation. Because of that, blood behaves as a non-Newtonian fluid. As such, the viscosity of blood varies with shear rate. Blood becomes less viscous at high shear rates like those experienced with increased flow such as during exercise or in peak-systole. Therefore, blood is a shear-thinning fluid. Contrarily, blood viscosity increases when shear rate goes down with increased vessel diameters or with low flow, such as downstream from an obstruction or in diastole. Blood viscosity also increases with increases in red cell aggregability.

<span class="mw-page-title-main">Polycythemia</span> Laboratory diagnosis of high hemoglobin content in blood

Polycythemia is a laboratory finding in which the hematocrit and/or hemoglobin concentration are increased in the blood. Polycythemia is sometimes called erythrocytosis, and there is significant overlap in the two findings, but the terms are not the same: polycythemia describes any increase in hematocrit and/or hemoglobin, while erythrocytosis describes an increase specifically in the number of red blood cells in the blood.

<span class="mw-page-title-main">Assessment of kidney function</span> Ways of assessing the function of the kidneys

Assessment of kidney function occurs in different ways, using the presence of symptoms and signs, as well as measurements using urine tests, blood tests, and medical imaging.

<span class="mw-page-title-main">Spirometry</span> Pulmonary function test

Spirometry is the most common of the pulmonary function tests (PFTs). It measures lung function, specifically the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled. Spirometry is helpful in assessing breathing patterns that identify conditions such as asthma, pulmonary fibrosis, cystic fibrosis, and COPD. It is also helpful as part of a system of health surveillance, in which breathing patterns are measured over time.

Compliance is the ability of a hollow organ (vessel) to distend and increase volume with increasing transmural pressure or the tendency of a hollow organ to resist recoil toward its original dimensions on application of a distending or compressing force. It is the reciprocal of "elastance", hence elastance is a measure of the tendency of a hollow organ to recoil toward its original dimensions upon removal of a distending or compressing force.

In renal physiology, renal blood flow (RBF) is the volume of blood delivered to the kidneys per unit time. In humans, the kidneys together receive roughly 20 - 25% of cardiac output, amounting to 1.2 - 1.3 L/min in a healthy adult. It passes about 94% to the cortex. RBF is closely related to renal plasma flow (RPF), which is the volume of blood plasma delivered to the kidneys per unit time.

In medicine, a biomarker is a measurable indicator of the severity or presence of some disease state. It may be defined as a "cellular, biochemical or molecular alteration in cells, tissues or fluids that can be measured and evaluated to indicate normal biological processes, pathogenic processes, or pharmacological responses to a therapeutic intervention." More generally a biomarker is anything that can be used as an indicator of a particular disease state or some other physiological state of an organism. According to the WHO, the indicator may be chemical, physical, or biological in nature - and the measurement may be functional, physiological, biochemical, cellular, or molecular.

The cardiac index (CI) is a hemodynamic measure that represents the cardiac output (CO) of an individual divided by their body surface area (BSA), expressed in liters per minute per square meter (L/min/m²). This parameter provides a more accurate assessment of heart function relative to the size of the individual, as opposed to absolute cardiac output alone. Cardiac index is crucial in assessing patients with heart failure and other cardiovascular conditions, providing insight into the adequacy of cardiac function in relation to the individual's metabolic needs.

<span class="mw-page-title-main">Pulmonary function testing</span> Test to evaluate respiratory system

Pulmonary function testing (PFT) is a complete evaluation of the respiratory system including patient history, physical examinations, and tests of pulmonary function. The primary purpose of pulmonary function testing is to identify the severity of pulmonary impairment. Pulmonary function testing has diagnostic and therapeutic roles and helps clinicians answer some general questions about patients with lung disease. PFTs are normally performed by a pulmonary function technologist, respiratory therapist, respiratory physiologist, physiotherapist, pulmonologist, or general practitioner.

Isotonic hyponatremia is a form of hyponatremia with mOsm measured between 280 and 295. It can be associated with pseudohyponatremia, or with isotonic infusion of glucose or mannitol.

Anemia is a condition in which blood has a lower-than-normal amount of red blood cells or hemoglobin. Anemia in pregnancy is a decrease in the total red blood cells (RBCs) or hemoglobin in the blood during pregnancy. Anemia is an extremely common condition in pregnancy world-wide, conferring a number of health risks to mother and child. While anemia in pregnancy may be pathologic, in normal pregnancies, the increase in RBC mass is smaller than the increase in plasma volume, leading to a mild decrease in hemoglobin concentration referred to as physiologic anemia. Maternal signs and symptoms are usually non-specific, but can include: fatigue, pallor, dyspnea, palpitations, and dizziness. There are numerous well-known maternal consequences of anemia including: maternal cardiovascular strain, reduced physical and mental performance, reduced peripartum blood reserves, increased risk for peripartum blood product transfusion, and increased risk for maternal mortality.

Positron emission tomography for bone imaging, as an in vivo tracer technique, allows the measurement of the regional concentration of radioactivity proportional to the image pixel values averaged over a region of interest (ROI) in bones. Positron emission tomography is a functional imaging technique that uses [18F]NaF radiotracer to visualise and quantify regional bone metabolism and blood flow. [18F]NaF has been used for imaging bones for the last 60 years. This article focuses on the pharmacokinetics of [18F]NaF in bones, and various semi-quantitative and quantitative methods for quantifying regional bone metabolism using [18F]NaF PET images.

References

  1. "How much blood is in the human body? What to know". June 2020.
  2. Lee, LanNa (1998). Elert, Glenn (ed.). "Volume of blood in a human". The Physics Factbook. Retrieved 2019-03-23.
  3. Dasselaar, JJ; van der Sande, FM; Franssen, CF (2012). "Critical evaluation of blood volume measurements during hemodialysis". Blood Purification. 33 (1–3): 177–82. doi:10.1159/000334142. PMID   22269777.
  4. 1 2 Yu, Mihae (2011). "A Prospective Randomized Trial Using Blood Volume Analysis in Addition to Pulmonary Artery Catheter, Compared with Pulmonary Catheter Alone, to Guide Shock Resuscitation in Critically Ill Surgical Patients". Shock. 35 (3): 220–228. CiteSeerX   10.1.1.693.1316 . doi:10.1097/shk.0b013e3181fc9178. PMID   20926981. S2CID   21290772.
  5. "History of Changes for Study: NCT02972294". 28 July 2022.
  6. "Maximum allowable blood loss | Iowa Head and Neck Protocols".
  7. Haldane, John; Smith, J. Lorrain (29 August 1900). "The mass and oxygen capacity of the blood in man". The Journal of Physiology. 25 (5): 331–343. doi:10.1113/jphysiol.1900.sp000800. PMC   1516699 . PMID   16992538.
  8. Manzone, T. A.; Dam, H. Q.; Soltis, D.; Sagar, V. V. (11 May 2007). "Blood Volume Analysis: A New Technique and New Clinical Interest Reinvigorate a Classic Study". Journal of Nuclear Medicine Technology. 35 (2): 55–63. doi: 10.2967/jnmt.106.035972 . PMID   17496003.
  9. Park, Junki; Puri, Sonika; Mattoo, Aditya; Modersitzki, Frank; Goldfarb, David (2012). "Radioisotope Blood Volume Measurement in Hemodialysis Patients" (PDF).
  10. Breenfeldt-Andersen, Andreas; Bonne, Thomas C.; Hansen, Joar; Oturai, Peter; Lundby, Carsten (May 2023). "Validation of a clinically applicable device for fast and accurate quantification of blood volume". Journal of Clinical Laboratory Analysis. 37 (9–10): e24928. doi:10.1002/jcla.24928. PMC   10388222 . PMID   37332175.
  11. Siebenmann, Christoph; Keiser, Stefanie; Robach, Paul; Lundby, Carsten (29 June 2017). "CORP: The assessment of total hemoglobin mass by carbon monoxide rebreathing". Journal of Applied Physiology. 123 (3): 645–654. doi: 10.1152/japplphysiol.00185.2017 . ISSN   8750-7587. PMID   28663373.
  12. 1 2 3 A Compendium of Drugs Used for Laboratory Animal Anesthesia, Analgesia, Tranquilization and Restraint Archived June 6, 2011, at the Wayback Machine at Drexel University College of Medicine. Retrieved April 2011
  13. Reynolds, Monica; Plasma and Blood Volume in the Cow Using the T-1824 Hematocrit Method American Journal of Physiology - June 1953 vol. 173 no. 3 421-427 doi:10.1152/ajplegacy.1953.173.3.421
  14. Wolfensohn & Lloyd, 2003, Handbook of Laboratory Animal Management and Welfare, 3rd Edition