Acute posthemorrhagic anemia in adults

Acute posthemorrhagic anemia in adults is a disease that arises from the rapid loss of large amounts of blood. Let's look at the main symptoms of the disease, the causes, methods of diagnosis, treatment and prognosis of acute posthemorrhagic anemia.

The pathological condition develops because of acute blood loss, which leads to a rapid decrease in the total volume of blood and plasma. Reduction of erythrocytes leads to acute hypoxia. Acute posthemorrhagic anemia leads to the symptoms of collapse. The patient feels weakness, dry mouth, vomiting, cold sweat, pallor, low blood pressure. The clinical picture of acute anemia is determined by the rate of blood loss, its amount and depends on the source of blood loss. Doctors use a special formula that helps to estimate the amount of blood loss.

П% = К + 44lgШИ,

Where П% - volume of lost blood, К - coefficient, 24 - injuries of limbs, 27 - gastrointestinal hemorrhage, 22 - trauma of thorax, 33 - cavitary bleeding, SHI (shock index) - ratio of pulse to pressure (systolic).

Let's look at the main misconceptions that concern acute posthemorrhagic anemia.

Misconception Truth Acute anemia only occurs because of heavy blood loss or poor nutrition. Anemia occurs because of persistent blood loss (hemorrhoids, bleeding gums, nosebleeds due to high or low blood pressure), lack of iron and an unbalanced diet. Observing the diet, you can restore the level of hemoglobin and prevent the development of acute anemia. One diet will not help prevent or cure anemia. Since the human body is able to assimilate only 2.5 mg of iron per day, obtained from products. Anemia does not necessarily have to be treated, since the body recovers. Acute anemia requires compulsory treatment. In the absence of proper medical care, the patient develops a pathological condition that can lead to a fatal outcome.

[1], [2], [3]

Causes of acute posthemorrhagic anemia

Causes of acute posthemorrhagic anemia are blood loss caused by injuries, injuries and damage to blood vessels. Reduction of the volume of circulating blood at a rapid pace, causes acute hypoxia, loss of plasma and ischemia of tissues and organs. This leads to a compensatory reaction of the body: increased secretion of hormones of the hypothalamus and activation of the RAA system, which leads to the mobilization of blood from the blood depot.

Anemia often occurs due to a violation of the integrity of blood vessels, bleeding in the lesions of the heart cavity, lungs, gastrointestinal tract, uterus, in case of complications during pregnancy and childbirth. The bigger the affected vessel and the closer it is to the heart, the more and more dangerous the bleeding. If there is a rupture of the aorta, it is enough to lose a liter of blood, which will lead to death due to a deficit of filling the heart cavities and a drop in blood pressure. That is, the lethal outcome is due to the bleeding of organs. If the bleeding has been stopped, then the body regains its functions over time.

In acute blood loss (more than 1000 ml of blood) for a short period of time, the patient has a shock and collapse. With such posthemorrhagic anemia, the pallor of the mucous membranes and skin, the noise in the ears, cold sweat, low blood pressure, convulsions, vomiting and a significant loss of iron, about 500 mg.

[4], [5], [6]

Symptoms of acute posthemorrhagic anemia

Symptoms of acute posthemorrhagic anemia begin with dizziness, nausea, and gastrointestinal disorders. Many patients noted dry mouth, thirst, the appearance of cold sweat, blanching of the skin, low blood pressure, pale and cold feet with blue under the fingernails. When you change the position of the body, dizziness increases, darkening in the eyes and loss of consciousness may occur.

Symptoms depend on the magnitude of blood loss, the rate of blood loss, from the channel from which blood flows, the severity of intoxication and the severity of the underlying disease, which led to posthemorrhagic anemia. Nonspecific symptoms of posthemorrhagic anemia are pallor of the mucous membranes, rapid fatigue, aversion to food, tachycardia, heart failure and heart murmurs, decreased hemoglobin and erythrocytes, shortness of breath, violation and even termination of the menstrual cycle. All the above symptoms require medical care and compulsory treatment.

Stages of acute posthemorrhagic anemia

Stages of acute posthemorrhagic anemia are three stages of the course of the disease. To accurately determine the stage, the patient conducts a hemogram. Let's consider the features of each stage of acute posthemorrhagic anemia.

• Reflex stage

This stage of the disease develops in the first 2-3 hours. Blood loss is characterized by a sharp decrease in plasma and erythrocytes, and the compensatory reaction leads the volume of the vascular bed in accordance with the level of blood circulation during reflex vasospasms. Very often at these stages, an erroneous diagnosis is made because of hidden bleeding.

• Hydromic stage

Develops within a day after the above. Due to the incoming interstitial fluid, the volume of circulating blood is restored. In patients, the blood is diluted due to the delay in fluid withdrawal. Erythrocytes and hemoglobin proportionally decrease.

• Bone marrow stage

Develops on the second day, begins erythroid growth and an increase in reticulocytes in the blood. In erythrocytes there are morphological changes that lead to the appearance of anisocytes and poikilocytes. Gradually develops thrombosis and neutrophilic leukocytosis. With proper treatment, recovery of blood levels is noted after 3-5 weeks.

Diagnosis of acute posthemorrhagic anemia

Diagnosis of acute posthemorrhagic anemia begins with finding out the reasons and taking into account information about acute blood loss. With significant bleeding, the diagnosis is based on clinical signs and laboratory tests.

The first stage of acute posthemorrhagic anemia does not provide an opportunity to trace the dynamics of decrease or vice versa increase in the volume of losses of circulating blood. This can be done by defining the shock index. If the blood loss is significant, then the index is used more than one, to obtain accurate results of lost blood and make a picture of blood in anemia.

[7], [8]

Picture of blood in acute posthemorrhagic anemia

The picture of blood in acute posthemorrhagic blood is information about the state of the body. The hematological picture depends entirely on the stage, that is, the period of hemorrhage. At the reflex stage, it is difficult to display the true picture of anemia, since blood loss can be of a hidden nature, which makes it difficult to diagnose. In the first stage, early signs of hemorrhage are neutrophilia, leukocytosis and thrombocytosis.

With severe anemia, which occurs 1-3 days after the hydromechanical phase of compensation, tissue fluid enters the circulatory system. At this stage, the degree of acute posthemorrhagic anemia is revealed, since a progressive decrease in erythrocytes and hemoglobin is observed. At this phase, the picture of blood has a normochromic character.

Recovery of red blood cells begins in 1-2 months and depends on the volume of blood loss. Recovery is due to the work of a reserve stock of iron in the body. But at this stage, the patient may begin to have iron deficiency, red blood cell hypochromia or microcytosis. The blood picture in acute posthemorrhagic anemia is an opportunity to monitor the dynamics of blood circulation in the body.

Treatment of acute posthemorrhagic anemia

Treatment of acute posthemorrhagic anemia is carried out only in the hospital. When transporting a patient to a hospital, the patient is transported in a specialized machine that allows medical personnel to conduct infusion therapy during transport. Bleeding is stopped only in a hospital. In especially severe cases, surgical intervention and infusion-transfusion therapy can be performed.

• Once the bleeding is stopped and the patient's condition is stabilized, acute posthemorrhagic anemia therapy with iron-containing drugs begins. With mild anemia, drugs are taken orally, and in severe cases, they are administered intravenously.
• Often, during the treatment of anemia, intravenous administration of iron-containing drugs is combined in the first days of therapy, followed by oral administration.
• As for transfusing blood or erythrocyte mass, this is possible only in severe stages of anemia. Similar therapy is performed before the hemoglobin level is raised to 60-80 g / l. Contraindicated take vitamin B12 and hematopoietic stimulants, which are used in the treatment of anemia.
• If the patient has significant blood loss, then the speed of transfusing blood is very important for stabilizing the patient's condition. It is strictly forbidden to replenish all blood loss, as this will lead to a syndrome of massive transfusions. Patients are never transfused with whole blood, as this is not advisable.
• To correct plasma proteins, patients are prescribed protein and albumin. To adjust the water balance, patients are infused with sodium chloride solution, glucose solution and Ringer-Locke solution. Lactosol is used to normalize the pH of the blood.

Prevention of acute posthemorrhagic anemia

Prevention of acute posthemorrhagic anemia consists in observing safety rules in order to prevent traumas that cause bleeding. It is also important to cure existing diseases, which are a potential danger of anemia. Adherence to a healthy lifestyle, rejection of bad habits and rational balanced nutrition is the most effective prevention of anemia.

Maintaining the body in tone, regular exercise, walking outdoors - improve blood circulation and prevent the development of the disease. Do not forget that lack of oxygen also causes symptoms of anemia. That's why, for prevention, you need to walk more often in the fresh air. In addition to the above-described preventive methods, alternative means are used to prevent anemia. Let's look at some of them.

• Vegetable infusions from dandelion, nettle and millennia restore the level of iron in the blood. It is useful to drink infusions and teas with currant leaves, mountain ash, hawthorn, dog rose, since these are natural sources of vitamin C.
• Fresh vegetables, fruits and greens are the source of iron, which must always be in the diet. For example, parsley and beets restore the daily loss of iron and are responsible for good health. Do not forget about the meat, because its shortage in the diet is the cause of anemia.
• With abundant menstruation, which can also cause anemia, it is recommended to use infusion of millennia. This will make it possible to replenish iron reserves and maintain normal body functioning.

Prevention is based on the observance of three simple rules: rational nutrition, constant movement and breathing. It is a pledge of good health and a healthy body.

Prognosis of acute posthemorrhagic anemia

The prognosis of acute posthemorrhagic anemia completely depends on the stage of the disease, the magnitude and nature of the blood loss. Small bleeding is not life threatening, but their relapse is a threat to health. Especial danger is acute and abundant blood loss, as they can lead to death, that is, the death of the patient.

Acute posthemorrhagic anemia has three stages of development, each of which is characterized by pathological symptoms requiring immediate medical attention. To prevent acute posthemorrhagic anemia, it is necessary to lead a healthy lifestyle, eat right and observe safety rules to prevent injuries that cause blood loss.