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HemodynamicsHemodynamicsHEMORRHAGEHEMORRHAGE
Dr.CSBR.Prasad, M.D.
HEMORRHAGEHEMORRHAGE• Hemorrhage - extravasation of blood due to rupture of BV• Capillary bleeding: Chronic congestion Hemorrhagic diatheses • Rupture of a large artery or vein - due to: Vascular injury Trauma Atherosclerosis Inflammatory Neoplastic erosion of the vessel wall
Manifestations – depends on size, Manifestations – depends on size, extent, and location of bleeding. extent, and location of bleeding.
• Hematoma (accumulation of blood within tissue )• Petechiae (1 - 2 mm hemorrhages into skin,
mucous membranes, or serosal surfaces )• Purpura (≥3 mm) • Ecchymoses (>1 - 2 cm) subcutaneous
hematomas • Large accumulations of blood in one or another of
the body cavities - hemothorax, hemopericardium, hemoperitoneum, or hemarthrosis
A - Punctate petechial hemorrhages of the colonic mucosa
B - Intracerebral hemorrhage
Consequences of thrombocytopenia
Petechial hemorrhages (pinpoint hemorrhages) seen on the epicardium
of the heart
Hemopericardium – Hemopericardium –
Cardiac tamponadeCardiac tamponade
Aortic tear with hemorrhages
Lacerated Liver – [Peritoneal hemorrhages]
Ecchymoses
Hematoma
Adrenal hemorrhageAdrenal hemorrhage
Raccoon Raccoon eyeseyes
HematomaHematoma
HematomaHematoma
Purpura - HSP
Subconjunctival hemorrhage
Subdural Subdural
hematomahematoma
Subdural hematomaSubdural hematoma
Subgaleal hemorrhageSubgaleal hemorrhage
Subgaleal Subgaleal hemorrhagehemorrhage
Clinical significance of hemorrhage Clinical significance of hemorrhage
Depends on the volume and rate of bleeding & blood loss: • Rapid loss of up to 20% of the blood volume or slow losses of even >20%
• Losses >20% may result in hemorrhagic (hypovolemic) shock
• The site of hemorrhage is also important: Trivial bleeding in the subcutaneous tissues – innocuous Trivial bleeding in the brain – may cause death
• External loss Vs Internal loss: Chronic or recurrent external blood loss – Loss of iron and IDA Hemorrhage into body cavities or tissues – No iron deficiency
No adverse effects
E N DE N Dgoto goto Hemostasis & Thrombosis