Anemia is best defined as a reduced RBC mass resulting in decreased oxygen-carrying capacity of the blood. Table 39-1 lists normal values for hemoglobin and hematocrit (Hct); values below the lower limits of normal for age and gender indicate only 25% likelihood that the person is not anemic. Previous Hb and Hct values for a given patient are useful comparisons when interpreting currently determined levels. Both pregnant women and long-distance athletes may have increases in plasma volume so that the Hct or the Hb value, or both, fall artificially below normal ranges. They still have a normal oxygen-carrying capacity with a normal RBC mass and should not be considered anemic. Conversely, a dehydrated patient admitted to the hospital may have Hb or Hct that appears normal because of plasma volume contraction. Correction of their volume-depleted state will allow appropriate determination of their true RBC oxygen-carrying capacity. When Hct or Hb is abnormal, further investigation is indicated, whether or not the subject appears clinically well.

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