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Medical Forum / General / General / February 2006Posthemorrhagic anemia question
I am looking for a classification of posthemorrhagic anemia types based on thier severity. It should have been published by the World Health Organization, but I couldn't find it. Anyone who knows where I can find this? Thanks in advance! > I am looking for a classification of posthemorrhagic anemia types based > on thier severity. It should have been published by the World Health > Organization, but I couldn't find it. Anyone who knows where I can find > this? > > Thanks in advance! I am somewhat confused about what you are asking about anemia types. Somebody can bleed to death very rapidly due to the blood loss. There is a loss of whole blood, red cells and plasma and if you measure the hemoglobin and hematocrit they will be normal. If you survive then the plasma is expanded over time and the reduction in Hgb and HCT is seen reflecting anemia. There is an increased pulse rate and decrease in blood pressure depending on the hypovolemia. The classification of Class I,II.III. IV is dependent on the blood loss volume http://www.emedicine.com/emerg/topic532.htm If Hb > 10g/dl transfusion is rarely indicated. If Hb < 7g/dl transfusion is usually necessary. With Hbs between 7 and 10 g/dl, clinical status, PvO2 and ER are helpful in defining transfusion requirements >> I am somewhat confused about what you are asking about anemia types. My friend was also. I should have mentioned that I am asking this on behalf of my friend, but that wouldn't wipe out the confusion... Anyway, this is a question that my friend ran into and that is all we know. We were looking all over the Internet (together with my friend), many books, but we found no such thing as classification of posthemorrhagic anemia types. It might be what you are suggesting, that it is not a "posthemorrhagic anemia" classificiation, but only a "posthemorrhagic" state classification. However, the question specificaly addresses anemia. No clue either. Many other people, including MSc-s, were unable to answer this question. It might be that this question is hand-made only to make confusion. Thanks for your answer, we might find something if we continue in the suggested direction. > >> I am somewhat confused about what you are asking about anemia types. > My friend was also. I should have mentioned that I am asking this on [quoted text clipped - 11 lines] > Thanks for your answer, we might find something if we continue in the > suggested direction. Acute blood loss is characterized as a normochromic normocytic anemia. Chronic blood loss can lead to iron deficiency anemia which is a microcytic hypochromic anemia based on the classification of red cell morphology and indices. The basic classification of all anemias is by size of the red cell into those with large red cells, macrocytic anemias and those with normal (normocytic) or small cells (microcytic) anemias. There is no posthemorrhagic (types) but only a single type associated with normal red cells or those cells found before the hemorrhage. The origins of the anemia is obvious and no need to subtype them. There is an obvious need to evaluate the degree of blood loss and so the classification based on blood loss is important in dictating the appropriate intervention. >I am looking for a classification of posthemorrhagic anemia types based > on thier severity. It should have been published by the World Health > Organization, but I couldn't find it. Anyone who knows where I can find > this? > > Thanks in advance! There is no specific classification. Blood loss is primarily divided into acute and chronic. The only "classification" that occurs is related to the patient's hemoglobin concentration. In a chronic setting, such as a duodenal ulcer or a colon cancer, the blood loss isn't quantified and the severity of the anemia is on based lab evaluation (hemoglobin/hematocrit and red cell morphology). In an acute setting, such as blood loss due to an injury or bleeding gastrointestinal lesion, the "classification" is based on the patient's hemodynamic status (heart rate, BP, LVEDP), since lab measurements will lag due to the body's attempt to equilibrate. In that latter *acute* setting, it's actually the level of hemorrhagic shock that is classified with a concomitant implied estimate of the amount of blood loss. So, from a practical standpoint, the only classification of chronic "posthemorrhagic anemia" is the actual lab numbers. Granted, when looking at those numbers, individual practicioners may relate those hemoglobin concentration numbers: HGB 12 and above = *yawn* down to HGB 5 and less = *holy sh.t!* Furthermore, the clinical relevance of that hemoglobin concentration is variable relative to the chronicity of the blood loss. Somebody with a slowly bleeding duodenal ulcer may walk into the office feeling a little tired and have an HGB of 5, in which case the workup would be far less emergent than someone in a car accident who might have an HGB of 5 and be in profound shock. HMc "Howard McCollister" <nospam@nospam.net> wrote in message > concentration numbers: > HGB 12 and above = *yawn* > > down to > > HGB 5 and less = *holy sh.t!* We view it the same way and expedite the workup of those with low HGB. > Furthermore, the clinical relevance of that hemoglobin concentration is > variable relative to the chronicity of the blood loss. Somebody with a [quoted text clipped - 4 lines] > > HMc We look at the blood and then guess as to which is the case based on morphology. Nutritional deficient anemias then we bought time. Normal blood cells then acute blood loss is implied. Bright yellow serum icteric then you fall into the "holy sh.t" category as alcoholic group with GI bleeding and expect a long night. We pray for a negative workup on antibody screen and any positives then you are in deep deep sh.t again. Most people think that all you need is the blood type of the person and give him blood. I wish it were that easy. |
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