Erythrocyte Sedimentation Rate (ESR) Lab Values

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Abby Rose

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Outline

Objective:

Determine the significance and clinical use of Erythrocyte Sedimentation Rate in clinical practice

Lab Test Name:

Erythrocyte Sedimentation Rate- ESR

Description:

The Erythrocyte Sedimentation Rate (ESR) test measures sedimentation of Red Blood Cells (RBCs).

In normal conditions, RBCs settle or sediment very little.

Inflammation affects proteins in the blood causing RBCs to stick and settle together out of the liquid portion of the blood.

Indications:

Identifies inflammation which assists in diagnosing:

Cancer
Infection
Autoimmune diseases

Normal Therapeutic Values:

Normal – 0-20 mm/hr

What would cause increased levels?

Increased

Conditions:

Anemia
Chronic Renal Failure
Systemic Lupus Erythematosus (SLE)
Infection
Tuberculosis
Pregnancy
Polymyalgia Rheumatica
Multiple myeloma

Medications:

Oral contraceptives
Theophylline
Vitamin A

What would cause decreased levels?

Decreased

Conditions:

Sickle cell anemia
Polycythemia Vera
Leukocytosis
Congestive Heart Failure (CHF)

Medications:

Aspirin
Cortisone
Quinine

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Transcript

Hey everyone, Abby from Nursing.com here. In this lesson, we will discuss ESR or erythrocyte sedimentation rate. We’ll talk about its normal value and times when we would see that value increase or decrease in clinical practice, let’s take a look.

Erythrocyte sedimentation rate measures, the sedimentation or the settling of red blood cells in a blood specimen tube. Now, in normal conditions, red blood cells don’t settle very much, but in times of inflammation, the blood, the red blood cells get really sticky and they do settle. They sediment down at the bottom as you can see here in some of these tubes. So, a clinical indication would be when inflammation is present. This lab is drawn to assist in diagnosing inflammatory disease and disorders like cancer, times of infection, and autoimmune diseases. Normal therapeutic values are between zero and 20 millimeters per hour. Isn’t that cool? It actually measures the distance that the red blood cells travel and sediment in the blood tube. Now, collection takes place in westergren tubes. So, these are specialized tubes that actually measure that distance.

When lab values are increased, it’s in conditions such as anemia or chronic renal failure. We talked about our autoimmune diseases and infection. It can also be increased in tuberculosis, pregnancy, polymyalgia rheumatica, and multiple myeloma. Certain medications can also cause an increase in the ESR like oral contraceptives, Theophylline, and vitamin A. The ESR will be decreased in conditions that affect the blood’s viscosity and also when we take into account the shape of red blood cells, so things like that would be sickle cell anemia, polycythemia, Vera leukocytosis, and even congestive heart failure. Certain medications will cause a decrease as well like aspirin, cortisone, and Quinine.

Our linchpins for this lesson are that the ESR or the erythrocyte sedimentation rate measures the distance that the RBCs travel as they sediment. A normal value is between zero to 20 millimeters per hour. Inflammatory marker is the ESR and it is measured in times of elevated inflammation and that’s when the result will also be elevated. The value will decrease depending on the blood’s viscosity and red blood cell shape. Remember, we talked about sickle cell anemia.

Now, you all did great on this lesson and go out, be your best self today. Remember, we’re always here for you. Happy nursing.