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ERYTHROCYTE SEDIMENTATION
RATE
PREPARED BY PUNAM SAHOO
INTRODUCTION
• When an anticoagulated blood is allowed to stand vertically , sedimentation of
erythrocyte occurs. The rate at which erythrocytes fall down, is known as
erythrocyte sedimentation rate (ESR).
• ESR is relatively simple , inexpensive, non specific test that has been used for
detect and monitor inflammation of various infections, cancers and autoimmune
disease .
PRINCIPLE
• Anticoagulated blood is taken in a tube and kept undisturbed in vertical position in
a stand . This will allow the sedimentation of erythrocytes . After a specific time,
generally 1 hour, the level of red cell is noted. The distance traveled by
erythrocytes in 1 hour is called as erythrocytes sedimentation rate (ESR).
STAGES OF ESR
There are 3 stages in erythrocyte
sedimentation
1) Stage 1 : Rouleaux formation -
First 10 minutes
2) Stage 2 : Stage of sedimentation
or settling - 40 mins
3) Stage 3 : Stage of packing - 10
minutes
METHODS OF ESR
• There are two methods of determination of ESR :-
1. WESRWEGEN METHOD
2. WINTROBE METHOD
WESTERGREN METHOD
REQUIREMENTS
• Westergren pipette
• Westergren stand
• Anticoagulant ( 3.8% trisodium citrate )
PROCEDURE
Fill the pipette by sucking blood up to 0 mark and fix it vertically in Westergren stand.
Read the upper level of RBC column exactly after 1 hour.
NORMAL RANGE –
Male – 0 to 5 mm/hr
Female – 0 to 7 mm/hr
WINTROBE METHOD
REQUIREMENTS
• Wintrobe pipette
• Wintrobe stand
• Anticoagulant (EDTA)
PROCEDURE
With the help of long necked Pasteur pipette or a special syringe , fill the
wintrobe tube up to 0 mark . Place the tube in an exactly vertical position in a
wintrobe stand. Read of RBC column exactly after 1 hour .
NORMAL RANGE
Male – 0 to 9 mm/hr
Female – 0 to 20 mm/hr
POSSIBLE ERRORS IN ESR
• The value of ESR can be affected by following errors:.
• Improper anticoagulant.
• The tube is not exactly vertical in position. Slight inclination may result in great difference in ESR
value. Three degrees angle of inclination may raise ESR up to 30%.
• Dirty tube.
• Bubble caused by too vigorous mixing of blood and anticoagulant.
• Hemolysis may modify ESR.
• Blood should be tested within 3 hours of collection. The prolonged storage may modify ESR.
• The stand should not be kept on vibrating surface.
• The reading should be taken exactly after1 hour.
• The stand should be kept away from window to avoid temperature variations.
limitation
Rapid ESR is found in :
chronic infection like tuberculosis, lymphatic fever . Myocardial infraction,
anemia, syphilis, malignant tumor, menstruation, liver disease etc. In pregnancy,
after second month, ESR is increased.
Slow ESR is found in :
Newborn infants, polycythemia, allergic conditions, heart failure etc.
ERYTHROCYTE SEDIMENTATION RATE. HEMATOLOGY

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ERYTHROCYTE SEDIMENTATION RATE. HEMATOLOGY

  • 2. INTRODUCTION • When an anticoagulated blood is allowed to stand vertically , sedimentation of erythrocyte occurs. The rate at which erythrocytes fall down, is known as erythrocyte sedimentation rate (ESR). • ESR is relatively simple , inexpensive, non specific test that has been used for detect and monitor inflammation of various infections, cancers and autoimmune disease .
  • 3. PRINCIPLE • Anticoagulated blood is taken in a tube and kept undisturbed in vertical position in a stand . This will allow the sedimentation of erythrocytes . After a specific time, generally 1 hour, the level of red cell is noted. The distance traveled by erythrocytes in 1 hour is called as erythrocytes sedimentation rate (ESR).
  • 4. STAGES OF ESR There are 3 stages in erythrocyte sedimentation 1) Stage 1 : Rouleaux formation - First 10 minutes 2) Stage 2 : Stage of sedimentation or settling - 40 mins 3) Stage 3 : Stage of packing - 10 minutes
  • 5. METHODS OF ESR • There are two methods of determination of ESR :- 1. WESRWEGEN METHOD 2. WINTROBE METHOD
  • 6. WESTERGREN METHOD REQUIREMENTS • Westergren pipette • Westergren stand • Anticoagulant ( 3.8% trisodium citrate ) PROCEDURE Fill the pipette by sucking blood up to 0 mark and fix it vertically in Westergren stand. Read the upper level of RBC column exactly after 1 hour. NORMAL RANGE – Male – 0 to 5 mm/hr Female – 0 to 7 mm/hr
  • 7.
  • 8. WINTROBE METHOD REQUIREMENTS • Wintrobe pipette • Wintrobe stand • Anticoagulant (EDTA) PROCEDURE With the help of long necked Pasteur pipette or a special syringe , fill the wintrobe tube up to 0 mark . Place the tube in an exactly vertical position in a wintrobe stand. Read of RBC column exactly after 1 hour . NORMAL RANGE Male – 0 to 9 mm/hr Female – 0 to 20 mm/hr
  • 9. POSSIBLE ERRORS IN ESR • The value of ESR can be affected by following errors:. • Improper anticoagulant. • The tube is not exactly vertical in position. Slight inclination may result in great difference in ESR value. Three degrees angle of inclination may raise ESR up to 30%. • Dirty tube. • Bubble caused by too vigorous mixing of blood and anticoagulant. • Hemolysis may modify ESR. • Blood should be tested within 3 hours of collection. The prolonged storage may modify ESR. • The stand should not be kept on vibrating surface. • The reading should be taken exactly after1 hour. • The stand should be kept away from window to avoid temperature variations.
  • 10. limitation Rapid ESR is found in : chronic infection like tuberculosis, lymphatic fever . Myocardial infraction, anemia, syphilis, malignant tumor, menstruation, liver disease etc. In pregnancy, after second month, ESR is increased. Slow ESR is found in : Newborn infants, polycythemia, allergic conditions, heart failure etc.