Hemolysis is what? Hemolysis of blood, partial hemolysis

The destruction of the erythrocyte membrane and the removal of hemoglobin into the plasma is called hemolysis. This process is due to the action of a special substance of haemolysin (hemolysin). Shells of erythrocytes can begin to break down because of the bacillary toxins or produced antibodies. Currently, physicians distinguish several varieties of this process. They are classified according to the mode of education, from the place in which it passes, from the reasons that can cause it.

Knowing that hemolysis is the destruction of erythrocytes, in which hemoglobin is released from them, many do not understand, because of what it can happen.

Factors that lead to the destruction of erythrocyte membranes

To understand the process itself, it is necessary to find out, because of what the destruction of red blood cells can begin. Depending on the mechanism of origin, the following types of hemolysis are distinguished.

1. Natural. This process is constantly in the body, it begins at the end of the usual life cycle of each of the red blood cells, which live about 100-130 days.

2. Chemical. It occurs when red blood cells are exposed to substances that can dissolve the lipids of the membrane. They include various alkalis, alcohols, ethers, chloroform. For example, hemolysis will be pronounced if a person is poisoned by a significant dose of acetic acid.

3. Biological. Shells of erythrocytes begin to break down due to the effects of hemolytic poisons, for example, as a result of insect bites or snakes. Also, biological hemolysis arises from the transfusion of incompatible blood.

4. Temperature. When the blood is frozen in erythrocytes, ice crystals are formed. After it is thawed, they tear the shell.

5. Mechanical. When the container is shaken with blood or when it is pumped by an apparatus that artificially maintains blood circulation, red blood cells are damaged.

6. Osmotic. If the red corpuscles fall into an environment where the osmotic pressure is lower than in the blood, then they can burst. This is their property used to diagnose anemia or liver disease.

Causes of hemolysis

To understand what and in what cases occurs with erythrocytes, it is necessary to fully understand the concept, such as hemolysis. This destruction of the shell of blood cells can occur inside cells or blood vessels. Usually these types of hemolysis are caused by various diseases. But also the shells of erythrocytes can be destroyed artificially in the process of laboratory research.

If we are talking about intravascular hemolysis, then the shells of red corpuscles in this case are damaged in the course of blood circulation. This occurs with the following diseases:

- hemolytic anemia, including autoimmune;

Paroxysmal nocturnal hemoglobinuria;

Paroxysmal cold agglutinin disease.

Also vnttriososudisty hemolysis may indicate poisoning with hemolytic poisons.

The destruction of erythrocytes inside cells occurs in the liver, spleen or bone marrow. It is observed in such health problems as hereditary microspherocytosis, autoimmune anemia and thalassemia. Knowing the causes that lead to the destruction of erythrocyte membranes, it becomes clear that hemolysis is dangerous. By the way, these intracellular processes are often accompanied by an increase in the size of the spleen and liver.

Symptoms of hemolysis

If erythrocytes have started to over-rupt in the human body, then they can be noticed only in the acute course of the disease. The most common signs of uncontrolled destruction of erythrocytes are such: jaundice of the skin or their pallor, lowering of pressure, rapid pulse. To attributes also carry fragility of nails and hair.

But often enough, many do not even suspect that they have hemolysis of the blood. What it is, they can learn by accident by going through a medical examination. But in the acute course often there is nausea, dizziness, fatigue, weakness and even a rise in temperature.

Hemolysis can cause anemia, which in turn is dangerous because it can cause increased thrombus formation or lead to the development of cholelithiasis.

Is there any reason for panic?

There are cases when patients of laboratories are forced to retake the tests because of the hemolysis of red blood cells. Many begin to look for signs of dangerous diseases, toxic lesions or simply poisoning. But in most cases there is no cause for concern, because the erythrocyte membranes can collapse due to mechanical factors. For example, often blood corpuscles can be damaged during the transfusion of blood into a test tube if a too thin needle is used or the nurse pumps blood quickly enough. Erythrocytes fight against the walls of the tube and burst. As a result, the plasma turns pink, and it is simply impossible to separate it into a centrifuge.

In such cases, it is said that a partial hemolysis occurred. This is not a disease, but the result of improper blood sampling, storage, transportation or handling. To conduct a reliable analysis, another portion of blood is needed. The patient is then advised to drink clean water before retaking the test.

Acute hemolysis

But if the cause of the decay of red blood cells is not in the nurse's fault, then it's about serious enough problems. Most often, acute hemolysis occurs with blood transfusion, when there are incompatible erythrocytes. As a result, this leads to activation of the complement system, coagulation and humoral immunity.

To reveal it is not difficult, because in this case hemolysis is a serious problem that gives a clear clinical picture. If the patient is conscious, he will complain of pain in the chest, lower back, abdomen, arousal, a feeling of heat, tachycardia. His pressure will be lowered. If hemolysis began during an operation conducted under general anesthesia, the signs will be the bleeding of the wound, and in the presence of a urinary catheter - it will appear urine of dark red or even black color.

Laboratory research

To confirm the diagnosis, tests are taken. If the patient has hemolysis, then according to the results of the blood test, thrombocytopenia, hemoglobinemia, bilirubinemia, anticoagulant potential and fibrinolysis will be revealed. In the urine, such a patient will have elevated levels of creatine, hemoglobinuria, hyperkalemia, a decrease in the amount of urine, until it is completely absent.

When confirming that blood cells are uncontrollably destroyed, appropriate therapy should be prescribed.

Treatment

Stop hemolysis of modern medicine is quite possible. If it was caused by blood transfusion, then treatment should be directed at stopping the infusion of hostile red blood cells. In addition, it is important to start transfusion of special solutions in a timely manner, which can prevent the development of hypovolemia, hypoperfusion of the kidneys. Also plasmapheresis is carried out, which is aimed at removing free hemoglobin from the circulating blood. To do this, in most cases, inject the drug "Heparin" intravenously with the help infuzomata. It helps to cope with acute hemolysis and the drug "Prednisolone". All appointments are made taking into account the condition of the patient, it is also important to know how long he began hemolysis. This helps doctors to determine the tactics of treatment, because in some cases it is necessary to carry out emergency hemodialysis. For example, it is necessary if it has been established that the patient has acute renal failure.

Medications as the cause of hemolysis

With the use of certain medications, red blood cells can also be destroyed. To the means that cause hemolysis of blood, include several groups of drugs.

1. Analgesics: "Amidopirin", "Acetylsalicylic acid", "Antipyrine".
2. Diuretics: "Fonurit", "Diakarb".
3. Nitrofurans: Furadonin, Furazolin.
4. Sulfonamides: "Sulfalen", "Salazosulfapyridine", "Salazopyridazine", "Sulfapyridazine".
5. Hypoglycemic drugs: Tolbutamide, Chlorpropamide.
6. Anti-TB drugs: Isoniazid, PASK.
7. Antimalarial medicines: "Quinine", "Akrihin", "Primachin".

When using these drugs, hemolysis of erythrocytes can be observed. This does not indicate any problems, it arises as a reaction to treatment.