Acute Anemia - Causes, Symptoms, and Treatment

Introduction:

Anemia is defined as a decrease in either the amount of circulating red blood cells (RBC), the amount of hemoglobin (Hgb), or the amount of packed red blood cells (hematocrit). World Health Organization defines anemia when the hemoglobin level in men is less than 13 g/dL and less than 12 g/dL in women. Anemia is further classified into the following types:

• Acute Anemia - It occurs when the red blood cell count suddenly drops, usually due to hemolysis (destruction of red blood cells) or acute bleeding.

• Chronic Anemia - It causes a gradual decrease in red blood cells. The causes include iron and other nutrient deficiencies, chronic disease, drug-induced, and other reasons.

What Is Acute Anemia?

Anemia refers to the lack of healthy red blood cells or hemoglobin. Hemoglobin, a protein found in red blood cells, carries oxygen from the lungs to all other organs in the body. Anemia can lead to fatigue, weakness, and shortness of breath. Acute anemia is caused due to sudden blood loss. The red blood cell count suddenly decreases. The breakdown of blood cells or acute bleeding often causes it. Acute bleeding can be due to surgery, injury, and childbirth and can also cause sudden, massive blood loss.

What Are the Causes of Acute Anemia?

Red blood cells have a total lifespan of 120 days. However, the body may destroy or eliminate them before completing their natural life cycle in the bloodstream. The destruction of red blood cells causes autoimmune hemolytic anemia. It occurs when the immune system mistakes red blood cells for foreign substances and attacks them. This may cause acute anemia due to the sudden breakdown of red blood cells by the body. Having a clotting disorder may also prevent the timely clotting of blood, which may lead to excessive blood loss during injury. A person can also undergo excessive blood loss during a surgical procedure.

Acute anemia can also be caused when red blood cells become fragile and can no longer withstand the stress of moving them through the body. They can burst, giving rise to hemolytic anemia (anemia caused by a low number of red blood cells due to their excess breakdown). A person may be born with this condition, or the reason for this may be unknown. Listed below may be the reasons for the breakdown of the red blood cells:

• An attack by the immune system is caused by an autoimmune condition. This can happen to anyone, even an unborn baby or a newborn. This is called hemolytic disease of the newborn. A condition that can be inherited through genes. Some autoimmune conditions include sickle cell anemia, thalassemia, and thrombotic thrombocytopenic purpura (TTP).

• An enlarged spleen can cause red blood cells to get trapped and quickly destroyed in rare cases.

• Infections, drugs, snake and spider venom, certain foods, and other things harm the blood.

• Toxins are produced from advanced liver or kidney disease.

• Clotting disorders.

• Tumors.

• Severe burns.

• Exposure to certain industrial chemicals and toxins.

What Are the Risk Factors for Acute Anemia?

Acute anemia can appear in people of all ages, genders, and ethnic origins. However, the following factors increase the risk of developing some symptoms:

• Premature birth.

• While giving birth.

• Having an internal injury leading to loss of blood.

• Having chronic conditions such as acquired immunodeficiency syndrome (AIDS), cancer, and Heart failure.

• Physical Injury.

• Having a clotting disorder.

• Work involving exposure to toxic chemicals.

• Having a chronic health condition.

• Being prone to infections.

What Are the Symptoms of Acute Anemia?

Symptoms of acute anemia may include the following:

• Fear or anxiety.

• Cold skin.

• Confusion.

• Pale skin color (pallor).

• Breathing fast.

• Sweaty and sticky skin.

• Decreased or no urine output.

• Loss of consciousness (lack of ability to react).

• The greater the amount of blood loss and the faster the rate of blood loss, the more severe the symptoms of shock.

• General weakness.

• Decreased blood pressure.

• Increased heart rate.

When to Get Help for Acute Anemia?

A person is advised to seek emergency medical help if they notice any signs of shortness of breath and dizziness. These signs can progress to life-threatening conditions. Immediate medical attention can help save a person’s life.

How Is Acute Anemia Diagnosed?

The tests used to diagnose acute anemia are listed below:

• Physical Exam: A complete physical exam is done to check for breathing, heartbeat, and size of the liver and spleen.

• Complete Blood Count: This test checks the hemoglobin and hematocrit levels in the blood. Hemoglobin is an iron-rich protein that is used by red blood cells that carry oxygen to the body. Hematocrit is a measurement of how much space red blood cells occupy in the blood. Anemia is a condition that involves low hemoglobin or hematocrit levels. A blood count also checks the number of white blood cells, red blood cells, and platelets in the blood. Abnormal results may indicate anemia, related blood disorder, infection, or some other medical conditions.

• Hemoglobin Electrophoresis: This test looks for various types of hemoglobin in the blood. This test helps diagnose the type of anemia.

• Blood Iron Level Test - These tests include blood iron and ferritin tests. Tests for transferrin levels and total iron-binding capacity also measure iron levels.

• Endoscopy Test - To check for an internal source of bleeding.

• Esophagogastroduodenoscopy (EGD) - Test for diagnosis and treatment of upper gastrointestinal tract bleed.

• Sigmoidoscopy or Colonoscopy - For the diagnosis of lower gastrointestinal tract bleed.

• Ultrasound - A rapid and non-invasive method for diagnosing intra-abdominal bleeding. Trauma-focused abdominal ultrasound (FAST) examination is commonly used to diagnose intra-abdominal bleeding in unstable trauma patients.

• Bone Marrow Biopsy Test - This test is done to investigate if the bone marrow is functioning properly and making enough red blood cells.

What Is the Treatment of Acute Anemia?

The ways of management of acute anemia are listed below:

Primary Management:

• Assess ABC - Airway, Breathing, and Circulation are checked.

• Supplemental oxygen is given to the person.

• Intravenous fluid resuscitation with crystalloids is given.

• Application of direct pressure to the area of bleeding.

Secondary Management:

• Packed red blood cells (pRBC) are the main treatment for acute anemia to restore blood loss. Each unit of pRBC is expected to increase hematocrit by 3 points.

• Other treatment options include other blood components like platelets, fresh frozen plasma (FFP), and cryoprecipitates.

• Vasopressors cause vasoconstriction by decreasing the blood flow.

What Are the Complications of Acute Anemia?

Serious complications can occur due to untreated acute anemia. Tissue hypoxia can cause end-organ damage, including myocardial infarction (heart attack), congestive heart failure, renal failure, acute hypoxic respiratory failure (lack of oxygen), or other end-organ damage.

Conclusion:

Sudden or abrupt loss or destruction of red blood cells may lead to a case of acute anemia. Blood loss is one of the most common causes of anemia, causing a direct loss of red blood cells. Another reason could be the destruction of red blood cells due to some underlying health condition or disease. Timely managing this condition may save a person's life from this potentially life-threatening condition.