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Post-hemorrhagic Anemia normocytic-normochromic anemia (NNA) image, COMMON…

- - - - Acute blood loss causes loss of intravascular volume, the effects depend on the rate of hemorrhage which leads to cardiovascular collapse, shock and ultimately death.
- - - - Volume loss reduces mean systemic filling pressure resulting in decreased venous return
        
        Initial manifestation causes the sympathetic nerve activation and a reduction in blood pressure, cardiac output & central venous pressure due to cardiovascular adaptations due to reduced blood volume.
        
        Lost Plasma is replaced by mobilizing water and electrolytes from tissues and interstitial spaces into the vascular system within the first 24 hours
        
        Concurrently
        
        Rapid elevation in circulating neutrophils and platelets
        
        Neutrophils can rise to 10,000-30,000/uL due to release from bone marrow
        
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        Platelet count can rise to 1 million/uL
        
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        This hemodilution results in lower hematocrit values
        
        ANEMIA
        
        If severe blood loss
        
        MORE IMMATURE CELLS may enter the circulation
        
        Metamyelocytes, myelocytes & nucleated red blood cells
        
        Reduced tissue oxygenation stimulates production of erythropoietin and increases production of erythrocytes in the bone marrow
        
        Iron stores may be depleted and erythropoiesis may be impeded
        
        If blood loss is not sever complete recovery is possible
      - Tissue damage
        
        Blood Loss
        
        Cytokine and Hormone Release
  - - - If iron stores are depleted iron deficiency anemia can occur
        
        Iron recovery from destroyed erythrocytes may occur
      - Bleeding Ulcers
      - Bleeding neoplasm
- - - - especially oral anticoagulants
- - - - Traumatic Coagulopathy
        
        Activation of fibrinolysis
      - Inflammation