.
Anemia
(anaemia
and anæmia; from ancient Greek, meaning lack of blood) is a
decrease in number of Red Blood Cell (RBCs) or less than the Normal
Quantity of hemoglobin in the blood. However, it can include decreased
oxygen-binding ability of each hemoglobin molecule due to deformity or lack in
numerical development as in some other types of Hemoglobin Deficiency.Because hemoglobin (found inside RBCs) normally carries Oxygen from the lungs to the tissues, Anemia leads to hypoxia (lack of oxygen) in organs. Since all human cells depend on Oxygen for survival, varying degrees of anemia can have a wide range of clinical consequences.
Anemia is the most common disorder of the blood.
The three main classes include excessive blood loss (acutely such as a hemorrhage or chronically through low-volume loss), excessive blood cell destruction (hemolysis) or deficient red blood cell production (ineffective hematopoiesis).
WHO's Hemoglobin thresholds used to define ANEMIA
(1 g/dL = 0.6206 mmol/L)
|
||
Age or gender group
|
Hb
threshold (g/dl)
|
Hb
threshold (mmol/l)
|
Children
(0.5–5.0 yrs)
|
11.0
|
6.8
|
Children
(5–12 yrs)
|
11.5
|
7.1
|
Teens
(12–15 yrs)
|
12.0
|
7.4
|
Women,
non-pregnant (>15yrs)
|
12.0
|
7.4
|
Women,
pregnant
|
11.0
|
6.8
|
Men
(>15yrs)
|
13.0
|
8.1
|
Treatments
Treatments for anemia depend on
severity and cause.
Oral
Iron : Iron deficiency from
nutritional causes is rare in men and postmenopausal women. The diagnosis of
iron deficiency mandates a search for potential sources of loss, such as
gastrointestinal bleeding from ulcers or colon cancer. Mild to moderate
iron-deficiency anemia is treated by oral iron supplementation with ferrous sulfate, ferrous
fumarate, or ferrous gluconate. When taking iron supplements,
stomach upset and/or darkening of the feces are commonly experienced. The
stomach upset can be alleviated by taking the iron with food; however, this
decreases the amount of iron absorbed. Vitamin C
aids in the body's ability to absorb iron, so taking oral iron supplements with
orange juice is of benefit.
Parenteral
Iron : In cases where oral iron has either
proven ineffective, would be too slow (for example, pre-operatively) or where
absorption is impeded (for example in cases of inflammation), parenteral
iron can be used. The body can absorb up to 6 mg iron daily from the
gastrointestinal tract. In many cases the patient has a deficit of over
1,000 mg of iron which would require several months to replace. This can
be given concurrently with erythropoietin to ensure sufficient iron for increased
rates of Erythropoiesis.
Transfusions
: Doctors
attempt to avoid blood transfusion in general, since multiple
lines of evidence point to increased adverse patient clinical outcomes with
more intensive transfusion strategies. The physiological principle that
reduction of oxygen delivery associated with anemia leads to adverse clinical
outcomes is balanced by the finding that transfusion does not necessarily
mitigate these adverse clinical outcomes. Blood does have risks associated,
such as disease transmission and host incompatibility, even in cases where
crossmatching was correctly undertaken. Each unit of blood is only equivalent
to 200–250 mg iron, thus requiring several units per patient to replete
iron stores. Increasingly, physicians are using parenteral
iron both to conserve a finite resource, for improved patient outcomes but
also to reduce costs to the hospital.
Hyperbaric
O2 : Treatment
of exceptional blood loss (anemia) is recognized as an indication for hyperbaric
oxygen (HBO) by the Undersea and Hyperbaric Medical
Society.[31][32] The use
of HBO is indicated when oxygen delivery to tissue is not sufficient in patients who
cannot be given blood transfusions for medical or religious
reasons. HBO may be used for medical reasons when threat of blood
product incompatibility or concern for transmissible disease are factors. The
beliefs of some religions (ex: Jehovah's Witnesses) may
require they use the HBO method.
Vitamin supplements
given orally (folic acid) or intramuscularly (vitamin
B12) will replace specific deficiencies.
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