Abstract
BackgroundOur primary purpose was to determine the normal range and variability of blood volume (BV) in healthy children, in order to provide reference values during childhood and adolescence. Our secondary aim was to correlate these vascular volumes to body size parameters and pubertal stages, in order to determine the best normalisation parameter.MethodsPlasma volume (PV) and red cell volume (RCV) were measured and F-cell ratio was calculated in 77 children with idiopathic nephrotic syndrome in drug-free remission (mean age, 9.8 ± 4.6 y). BV was calculated as the sum of PV and RCV. Due to the dependence of these values on age, size and sex, all data were normalised for body size parameters.ResultsBV normalised for lean body mass (LBM) did not differ significantly by sex (p < 0.376) or pubertal stage (p < 0.180), in contrast to normalisation for the other anthropometric parameters. There was no significant difference between reference values for children and adults.ConclusionLBM was the anthropometric index most closely correlated to vascular fluid volumes, independent of age, gender and pubertal stage.
Highlights
Our primary purpose was to determine the normal range and variability of blood volume (BV) in healthy children, in order to provide reference values during childhood and adolescence
In the largest study performed to date in a paediatric population, 160 infants and children aged 1 hour to 14 years [5], BV was calculated from plasma volume and haematocrit using a fixed F-cell ratio of 0.91, derived from studies in adults [6]
We observed significant differences between the sexes for body fluid volumes normalised for BMI, body weight (BW) and body surface area (BSA), but not when we normalised BV for H and lean body mass (LBM). When we assorted these values by pubertal stage, we found that only LBM show no statistical difference for gender (Fig 1a, b, c, d)
Summary
Our primary purpose was to determine the normal range and variability of blood volume (BV) in healthy children, in order to provide reference values during childhood and adolescence. To evaluate changes in BV in children under different clinical conditions, it is necessary to obtain reference values. Despite the importance in daily clinical practice, only few direct measurements of blood volume have been performed in children. The F-cell ratio, which determines the relative distribution of BV between the microvasculature and the large vessels, describes the relation between whole body and large vessel haematocrit. Use of a fixed F-cell-ratio of 0.91 disregards large interindividual variability in adults [7,8], but presumes that the distribution of large and small vessels in children and adults is comparable, despite their significantly different body compositions. To obtain reliable BV measurements, plasma volume (PV) and red cell volume (RCV) [7,9]
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