Someone once asked me how is it possible that a patient with a single digit PCV would still be alive?
Well, I've seen a patient walking with a PCV of 9. Let me tell you why it is possible.
HAEMATOLOGY 101:
A single digit PCV is profoundly severe anemia and is life-threatening...
but in haematology there is something we call CARDIOVASCULAR COMPENSATORY RESPONSE TO SEVERE ANEMIA -
particularly Increased Cardiac Output.
You know the function of red blood cells is to carry and distribute oxygen around the body. But when the Hemoglobin/PCV becomes extremely low it means the blood will carry lesser oxygen. So for the patient to stay alive the body will try to maintain tissue oxygen delivery by setting in motion the cardiovascular compensatory mechanism.
This is how the mechanism works:
- The heart rate will increase (tachycardia) so the heart will begin to pump more blood per beat
- Through tachycardia the Cardiac Output will increase
- As cardiac output increases, blood flow will then be redistributed to only the vital organs that will keep the patient alive (e.g: brain, kidney, heart, etc)
- During this period the 2,3-biphosphoglycerate (2,3-BPG) causes more oxygen to be released from the red blood cells (2,3-BPG is a substance in the red cells that regulates oxygen release)
So this is why a patient with a single digit PCV can sometimes remain conscious and alive because the cardiovascular system has compensated.
But this can only be possible if the anemia developed gradually so that the body can have time to carry out all these processes.
Survival at such levels doesn't mean the value is "safe"; it means compensatory mechanisms may temporarily be maintaining adequate tissue oxygenation.
I hope this has enlightened someone who used to wonder how someone with a PCV of 9 is still alive.
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