Posthemorrhagic anemia

Description:

Posthemorrhagic anemia — an iron deficiency anemia which develops after blood loss. Posthemorrhagic anemias are subdivided on acute and chronic. Acute posthemorrhagic anemia develops after the plentiful, sharply arising bleedings. Chronic posthemorrhagic anemias develop after long not plentiful bleedings.

Symptoms of Posthemorrhagic anemia:

At posthemorrhagic anemia clinically to the forefront there are phenomena of acute vascular insufficiency owing to sharp devastation of a vascular bed (hypovolemia): — this heartbeat, asthma, orthostatic collapse). Weight of a state is defined not only by quantity, but also blood loss speed. Decrease in a diuresis according to blood loss degree is observed. Level of hemoglobin and quantity of erythrocytes are not reliable criterion of degree of blood loss.

The first minutes the maintenance of Hb because of reduction of OTsK can be even high. At receipt of an intercellular lymph in a vascular bed these indicators decrease even at the termination of bleeding. The color indicator is, as a rule, normal as there is a simultaneous loss and erythrocytes and iron, that is anemia normokhromny. The quantity of reticulocytes reaching a maximum for 4 — 7 day increases by second day, that is anemia is hyper regenerator.

Reasons of Posthemorrhagic anemia:

    * injuries
    * hemorrhagic diseases (trombotsitopatiya, coagulopathies, the IDCS, a hemorrhagic vasculitis, leukoses, aplastic anemias, dizovarialny menorrhagias at girls).
    * pulmonary bleeding, bleeding ZhK

Treatment of Posthemorrhagic anemia:

The most important — to eliminate a bleeding point. Then fill blood loss (depending on severity of anemia — a packed red cells, against the background of administration of heparin). The total amount of a hemotransfusion should not exceed 60% of deficit of volume of the circulating blood. Other volume is filled with blood substitutes (5% albumine solution, reopoliglyukiny, Ringer's solution etc.). A limit of hemodilution consider a hematocrit 30 and erythrocytes more than 3*10 ¹ ²/l. Upon termination of the acute period treatment of a prepapratama of iron, vitamins of group B, C, E is necessary. After elimination of anemia iron preparations are appointed in a half dose up to 6 months.