Acute posthemorrhagic anemia in adults

Acute posthemorrhagic anemia in adults is a disease that occurs due to rapid loss of a large amount of blood. Let's look at the main symptoms of the disease, causes, diagnostic methods, treatment and prognosis of acute posthemorrhagic anemia.

The pathological condition develops due to acute blood loss, which leads to a rapid decrease in the total volume of blood and plasma. A decrease in red blood cells leads to acute hypoxia. Acute posthemorrhagic anemia leads to symptoms of collapse. The patient feels weak, has a dry mouth, vomiting, cold sweat, pallor, and 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 volume of blood loss.

P%=K+44lgШИ,

Where P% is the volume of lost blood, K is the coefficient, 24 is limb injuries, 27 is gastrointestinal blood loss, 22 is chest trauma, 33 is cavity bleeding, SI (shock index) is the ratio of pulse rate to pressure (systolic).

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

Misconception Truth Acute anemia occurs only due to heavy blood loss or poor nutrition. Anemia occurs due to constant blood loss (hemorrhoids, bleeding gums, nosebleeds due to high or low blood pressure), iron deficiency and unbalanced nutrition. By following a diet, you can restore hemoglobin levels and prevent the development of acute anemia. Diet alone will not help prevent or cure anemia. Since the human body can absorb only 2.5 mg of iron per day from food. Anemia does not necessarily need to be treated, since the body recovers. Acute anemia requires mandatory treatment. Without proper medical care, the patient develops a pathological condition that can lead to death.

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Causes of acute posthemorrhagic anemia

The causes of acute posthemorrhagic anemia are blood loss that occurs during trauma, wounds and damage to blood vessels. A rapid decrease in the volume of circulating blood causes acute hypoxia, loss of plasma and ischemia of tissues and organs. This leads to a compensatory reaction of the body: secretion of hypothalamic hormones and activation of the RAA system increases, which leads to mobilization of blood from the blood depot.

Anemia most often occurs due to the violation of the integrity of blood vessels, bleeding in lesions of the cavities of the heart, lungs, gastrointestinal tract, uterus, in case of complications during pregnancy and childbirth. The larger the affected vessel and the closer it is to the heart, the greater and more dangerous the bleeding. If an aorta ruptures, then it is enough to lose a liter of blood, which will lead to death due to the deficiency of filling of the cavities of the heart and a drop in blood pressure. That is, a fatal outcome occurs due to the exsanguination of organs. If the bleeding has been stopped, then over time the body restores its functions.

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

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Symptoms of acute posthemorrhagic anemia

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

Symptoms depend on the amount of blood loss, the rate of blood loss, the bloodstream from which the blood flows, the severity of intoxication and the severity of the underlying disease that led to posthemorrhagic anemia. Non-specific symptoms of posthemorrhagic anemia are: pale mucous membranes, rapid fatigue, aversion to food, tachycardia, heart failure and heart murmurs, decreased hemoglobin and red blood cells, shortness of breath, disruption and even cessation of the menstrual cycle. All of the above symptoms require medical care and mandatory treatment.

Stages of acute posthemorrhagic anemia

The stages of acute posthemorrhagic anemia are three stages of the disease. To accurately determine the stage, the patient undergoes 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 brings the volume of the vascular bed in line with the level of blood circulation during reflex vascular spasms. Very often at these stages, an erroneous diagnosis is made due to hidden bleeding.

• Hydremic stage

Develops within 24 hours after the above. Due to the incoming interstitial fluid, the volume of circulating blood is restored. Patients' blood becomes thinner due to the delay in the removal of fluid. Erythrocytes and hemoglobin decrease proportionally.

• Bone marrow stage

It develops on the second day, erythroid growth and an increase in reticulocytes in the blood begin. Morphological changes occur in the erythrocytes, which lead to the appearance of anisocytes and poikilocytes. Thrombosis and neutrophilic leukocytosis gradually develop. With proper treatment, the restoration of blood counts is noted after 3-5 weeks.

Diagnosis of acute posthemorrhagic anemia

Diagnosis of acute posthemorrhagic anemia begins with identifying the causes and taking into account information about acute blood loss. In case of significant bleeding, diagnosis is based on clinical signs and laboratory tests.

The first stage of acute posthemorrhagic anemia does not allow tracking the dynamics of decrease or, on the contrary, increase in the volume of circulating blood loss. This can be done by determining the shock index. If blood loss is significant, then an index greater than one is used to obtain accurate results of lost blood and to draw up a blood picture for anemia.

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Blood picture in acute posthemorrhagic anemia

The blood picture in acute posthemorrhagic blood provides information about the state of the body. The hematological picture completely depends on the stage, i.e. the period of blood loss. At the reflex stage, it is difficult to display the true picture of anemia, since blood loss can be hidden, which complicates diagnosis. At the first stage, early signs of blood loss are neutrophilia, leukocytosis and thrombocytosis.

In severe anemia, which occurs 1-3 days after the hydremic compensation phase, tissue fluid enters the circulatory system. At this stage, the degree of acute posthemorrhagic anemia is revealed, as a progressive decrease in red blood cells and hemoglobin is observed. At this phase, the blood picture is normochromic.

Restoration of red blood cells begins in 1-2 months and depends on the volume of blood loss. Restoration occurs due to the work of the body's iron reserve fund. But at this stage, the patient may develop iron deficiency, red blood cell hypochromia or microcytosis. The blood picture in acute posthemorrhagic anemia is an opportunity to track the dynamics of the blood circulation level in the body.

Treatment of acute posthemorrhagic anemia

Treatment of acute posthemorrhagic anemia is performed only in a hospital. When transporting a patient to a hospital, the patient is transported in a specialized vehicle that allows medical personnel to perform infusion therapy during transportation. Bleeding is stopped only in a hospital setting. In particularly severe cases, surgical intervention and infusion-transfusion therapy may be performed.

• Once the bleeding has stopped and the patient's condition has stabilized, therapy for acute posthemorrhagic anemia begins with iron-containing drugs. For mild anemia, the drugs are taken orally, and for severe anemia, 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 red blood cell mass, this is possible only in severe stages of anemia. Such therapy is carried out until the hemoglobin level increases to 60-80 g/l. It is contraindicated to take vitamin B12 and hematopoiesis stimulants, which are used in the treatment of anemia.
• If the patient has significant blood loss, the speed of blood transfusion is of great importance to stabilize the patient's condition. It is strictly forbidden to replenish all blood loss, as this will lead to massive transfusion syndrome. Patients are never transfused with whole blood, as this is not advisable.
• To correct plasma proteins, patients are prescribed protein and albumin. To correct the water balance, patients are infused with sodium chloride solution, glucose solution and Ringer-Locke solution. To normalize blood pH, Laktosol is used.

Prevention of acute posthemorrhagic anemia

Prevention of acute posthemorrhagic anemia consists of following safety rules to prevent injuries that cause bleeding. It is also important to treat existing diseases that are a potential danger of anemia. Maintaining a healthy lifestyle, giving up bad habits and a rational balanced diet are the most effective prevention of anemia.

Keeping the body in good shape, regular physical exercise, walks in the fresh air - improve blood circulation and prevent the development of the disease. Do not forget that lack of oxygen also causes symptoms of anemia. That is why, for prevention, it is necessary to walk in the fresh air more often. In addition to the above-described preventive methods, folk remedies are also used to prevent anemia. Let's look at some of them.

• Herbal infusions of dandelion, nettle and yarrow restore iron levels in the blood. It is useful to drink infusions and teas with currant leaves, rowan, hawthorn, rose hips, as these are natural sources of vitamin C.
• Fresh vegetables, fruits and greens are a source of iron, which should always be in the diet. For example, parsley and beetroot restore daily iron losses and are responsible for good health. Do not forget about meat, since its lack in the diet is the cause of anemia.
• In case of heavy menstruation, which can also cause anemia, it is recommended to use yarrow infusion. This will help to replenish iron reserves and maintain normal functioning of the body.

Prevention is based on following three simple rules: rational nutrition, constant movement and breathing. This is the key to good health and a healthy body.

Prognosis of acute posthemorrhagic anemia

The prognosis of acute posthemorrhagic anemia depends entirely on the stage of the disease, the amount and nature of blood loss. Minor bleeding is not life-threatening, but its recurrence is a threat to health. Acute and profuse blood loss is especially dangerous, as it can lead to a fatal outcome, i.e. the death of the patient.

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