Hyperbaric oxygen therapy in exceptional blood loss anemia
Acute blood loss (anemia) is characterized by sufficient decrease in
red blood cells (RBC) due to acute hemorrhage (bleeding) or
hemolysis (RBC destruction). The function of the RBC is to deliver
oxygen from the lungs to the tissues and carbon dioxide from the
tissues to the lungs. When oxygen delivery to the tissue is disturbed
by anemia the most sensitive body tissues that require constant oxygen
supply: brain and heart will be first to be affected.
Symptoms:
Neurological – agitation, restlessness and loss of consciousness when
blood loss exceeds 40% of total volume.
Cardiovascular and respiratory - increased heart rate (tachycardia),
increased respiratory rate (tachypnea) and blood loss greater than 50%
leads to loss of pulse and blood pressure
Genitourinary - urinary output is decreased and kidney failure develops.
Causes of acute anemia:
- Large blood loss in life-threatening situation such as
traumatic injury, massive gastrointestinal hemorrhage, ruptured ectopic
pregnancy, ruptured aneurysms, and disseminated intravascular
coagulation
- Hemoglobinopathies - sickle cell anemia, thalassemias
- Enzyme abnormalities - Glucose-6-phosphate dehydrogenase
(G-6-PD) and pyruvate kinase deficiency
- Congenital coagulopathy -von Willebrand factor (VWF),
HemophiliaA, Hemophilia B
- Autoimmune hemolysis
- Platelet disorders
- Hemolytic - uremic syndrome
Hyperbaric oxygen is used in acute blood loss anemia when:
- Person cannot accept blood transfusion for religious reason
(Jehovah’s Witnesses)
- Cross-matched transfusion is not possible (certain
hemolytic anemias)
- In shock, when systolic blood pressure is below 90 mmHg
- Disorientation or coma due to anemia
- Ischemic gut and kidney
