ESR-Auto Plus Operator’s Manual 47
THE SEDIMENTATION REACTION
7.6 A Typical ESR Reaction
In order to understand the advantages of the ESR-Auto Plus
and the 30-minute method, it is important to understand the
course of development of ESR.
A number of factors affect the sample during its reaction,
which can make ESR quite unspecific; however, they also
make ESR a wide screening marker for disease. The reaction
contains several phases that affect the end result in various
ways. Generally, the reaction can be divided into three basic
phases: Aggregation, Sedimentation and Packing (Figures
21 and 22).
Aggregation
The Aggregation Phase occurs during the first 5 to 10 minutes
of the reaction as the red blood cells aggregate. The reaction
during this time is not known to correlate to any disease
state. Almost no sedimentation of the red cells occurs during
this phase. However, the degree of aggregated cells will
determine the sedimentation rate during the second phase.
Sedimentation
Sedimentation of red blood cells occurs during the
Sedimentation Phase since red blood cell aggregates are
denser than plasma. The sedimentation rate is often linear
during the major part of this phase.
Packing
As sedimented red blood cells reach a certain density,
sedimentation will decrease and come to an end. This is the
Packing Phase where the blood divides into distinct layers of
red blood cells, white blood cells and plasma.
7.7 ESR Reference Ranges / Values
Guidelines for ESR Reference Values for the Westergren
ESR Method*: Normal 0-20mm/hr
* Follow CLSI
Procedures for the Erythrocyte Sedimentation
Rate Test
;
Approved Standard
. CLSI document H02.
Reference values should be established locally in accordance
with the individual laboratory’s accrediting agencies. Refer to
CLSI document H02 for age and gender-specific reference
values.
Figure 21: Before the ESR reaction has come to
a stop, a number of factors have participated and
affected the result.
Figure 22: The ESR reaction can be divided into
three phases: 1. Aggregation, 2. Sedimentation,
and 3. Packing.
Minutes
Summary of Contents for ESR-Auto Plus 506
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