Situation	Interpretation
Hb low but HCT normal	Plasma dilution / analyzer issue
Hb normal but HCT low	RBC swelling / hemolysis artifact
Both low but mismatch	Sample or timing error
Hb × 3 ≠ HCT	Report unreliable

BEFORE TRANSFUSION ALWAYS REMEMBER

• Hb points oxygen capacity.
• HCT points red cell mass.
• If they disagree → stop and repeat CBC.

MCV	RDW	Meaning
High	Normal	Analyzer delay, EDTA swelling
High	High	True macrocytosis (B12, folate, MDS)
Low	High	Iron deficiency
Normal	High	Mixed anemia
Any	Normal	Uniform population

Report says

• Macrocytosis + ↑ RDW → real disease
• Macrocytosis + normal RDW → artifact or uniform swelling

So for DIALYSIS , PATIENTS

• Are often fluid overloaded.
• Have poor cardiac reserve.
• Have altered RBC survival.
• Are often on EPO.
• Not always need stat PRBC Transfusion

BECAUSE IN PATIENTS WITH DIALYSIS + CARDIAC DISEASE , HARM IS NOT ANEMIA — HARM IS VOLUME + VISCOSITY + OXYGEN DEMAND MISMATCH.

SO IN CARDIAC/DIALYSIS Patients :

More blood ≠ better oxygen delivery always.

SOMETIMES TRANSFUSIONS WORSEN MYOCARDIAL WORKLOAD.