Posthemorrhagic Anemia

– An anemia characterized by a decrease in hemoglobin in the blood related to rapid, massive hemorrhage.

Causes and Incidence

Rapid blood loss may be caused by traumatic rupture or incision or erosion of a large blood vessel (ulcer, tumor). The prognosis depends on the rate and site of bleeding and the total blood loss.

Disease Process

With blood loss, blood volume diminishes, hemodilution occurs, and oxygenation of the tissues declines.

Symptoms

The rate of blood loss determines the signs and symptoms, which may include dizziness; faintness; weakness; pallor; thirst; sweating; rapid, weak pulse; rapid respiration; and orthostatic hypotension.

Potential Complications

Lack of prompt treatment or failure to control the bleeding results in shock, coma, and death.

Diagnostic Tests

Complete blood count
RBCs, Hgb, and Hct are deceptively high during initial period of hemorrhage because of vasoconstriction; values begin to decline within hours of the onset of bleeding if hemorrhage is not controlled.

Peripheral smear
Normocytic cells, agranulocytosis.

Coagulation time
Reduced.

Treatments

Surgery – If indicated to control hemorrhage.

Drugs – Iron replacement.

General – Control of bleeding; blood transfusions; IV fluids, oral fluids as tolerated; oxygen; absolute bed rest; diet high in protein and iron.

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