The Facts on Blood Loss, Transfusions, and Transfusion Alternatives

Blood carries oxygen and nutrients to the tissues and organs and removes waste products. It is made up of
several main components, including red blood cells, white blood cells, platelets, and plasma. Red blood cells carry
and release oxygen throughout the body. White blood cells are part of your immune system and help fight infection.
Platelets help the blood form clots, which stops bleeding.
Blood cells are suspended in a watery, yellowish liquid called plasma, which also contains proteins partly responsible
for blood clotting and globulins that help fight infection and disease.
There are approximately 4 L to 5 L of blood in the body. Losing large amounts of blood quickly can lead to serious
complications or death. Severe blood loss is usually treated with a transfusion or transfusion alternatives such as
medications.
Causes of Blood Loss, Transfusions, and Transfusion Alternatives
There are many possible causes of blood loss. Accidents, surgery, childbirth, stomach ulcers, and blood vessel
rupture can cause a sudden loss of blood. In addition, illnesses such as cancer and leukemia often result in lowerthan-normal numbers of blood cells. Some conditions, such as heavy menstrual bleeding, cause a gradual blood loss
over a long period of time.
Although all types of blood loss may cause complications, it is the large and rapid blood losses that occur during
surgery and trauma that are most likely to cause severe complications or death. The amount of blood loss that may
lead to complications depends on the individual person. It is affected by factors such as body size and the presence
of certain health conditions (e.g., anemia).
A person's risk of blood loss severe enough to require a transfusion during surgery depends on a number of factors,
including gender (women generally have a higher risk because they have a smaller volume of blood), health status
(conditions such as hemophilia increase the risk of bleeding), and medications or herbs they may be taking (blood
thinners such as warfarin* can increase the risk of bleeding).

Symptoms and Complications of Blood Loss, Transfusions, and Transfusion Alternatives

The effects of blood loss depend on a person's general state of health, the amount of blood lost, and how
quickly it was lost. Bleeding may be internal or external. With external bleeding, blood leaves the body through a
break in the skin (from a wound, trauma, or surgery), or a body opening such as the mouth, anus, or vagina.
With internal bleeding, blood is lost from the blood vessels, but stays inside the body, often leading to swelling and
pain. Both internal and external bleeding can lead to serious complications. Internal bleeding may be harder to
recognize and diagnose because the bleeding is not visible.
The more blood is lost, and the faster it is lost, the more severe the symptoms and complications.
The symptoms of blood loss include:

abdominal pain or swelling (a symptom of internal bleeding)

bleeding during surgery

bleeding from the mouth

blood coming from a break in the skin

blood coming from the vagina (unexpectedly, or much more than expected)

blood in the stool (the stool may be black and tarry or red)

blood in the urine (the urine may be pink, red, or brownish in colour)

bruising (a bruise forms when there is blood under the skin)

cool, clammy skin

dizziness, weakness, or confusion

fast, weak pulse

paleness

trouble breathing

vomiting blood or material that looks like coffee grounds

The complications of blood loss are related to the role blood plays in the body (see above). If too much blood volume
is lost, a condition known as hypovolemic shockcan occur. Hypovolemic shock is a medical emergency in which
severe blood and fluid loss impedes the heart to pump sufficient blood to the body. As a result, tissues cannot get
enough oxygen, leading to tissue and organ damage. If left untreated, this condition can be fatal. Complications can
be more serious in people taking blood thinners or those with bleeding disorders.