What is a blood count?
Hematology analyzers are equipment used to perform complete blood counts, or blood counts. A complete blood count (CBC) or hematologic analysis reflects all elements or components of blood, reflecting their number or proportion in the individual. This test measures white blood cell (WBC) series, red blood cell (RBC) series, and platelets.
Complete blood count is the most requested diagnostic test. It provides a multiparametric evaluation of blood components, including red blood cells, white blood cells, and platelets. The results inform the well-being of the patient and allow the diagnosis of diseases such as anemia, infections and leukemia. Traditionally, CBCs are done in clinical laboratories using automated hematologic analysers.
This examination provides information about hematocrit (Hct), hemoglobin (Hb) concentration, mean corpuscular hemoglobin (MCHC) concentration, mean corpuscular volume (MCV), red blood cell count, white blood cells, and platelets.
In addition, it gives us information on red blood cell size dispersion (RDW) (red blood cell distribution), which is expressed in % and represents the coefficient of variation in red blood cell sizes. Blood counts also include blood smear testing of blood elements, which may be particularly useful in patients with anemia, but also white blood cell or platelet abnormalities may be diagnostic.
What measurement technologies do hematology analyzers use?
It is important to know the counting technology used by the device, as the results may vary depending on one or the other:
- Flow cytometry: it is the most sophisticated and expensive method available today. The cells pass through a narrow tube onto which a laser beam is projected. Light enters the cells, and a detection device picks up their reflex. In this case, laser flow cytometry is talked about.
- Electrical impedance: this technique is used to determine the number and volume of red blood cells and thrombocytes. EDTA blood is diluted with an isotonic solution within the device and aspirated through a capillary orifice.
- Laser diffraction: it measures the particle’s particle size distribution. Angular variation of diffuse light intensity is measured when a laser beam passes through a sample of scattered particles.
What are the keys to a correct interpretation of the results reported by the 5-part hematological analyzers?
First, you need to understand the technology of the analyser, that is, how it obtains the information it provides: how is it generated?, where does it come from? In addition, you should know where alarms are observed, why they are generated and what each of them means, have knowledge about the software and proper handling of each of the screens.
The smear does not always need to be checked. It is advisable to develop decision trees and maps that can be used to decide whether or not to automatically release the results of differentials, platelet counts, and other parameters, or whether to proceed to manual review.
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