How Does Hemorrhage Cause Death
Hemorrhage causes death by interrupting blood flow to the brain or heart, resulting in oxygen deprivation that damages the ability of nerve cells to function

Hemorrhage causes death by interrupting blood flow to the brain or heart—resulting in oxygen deprivation that damages the ability of surrounding nerve cells to function, which eventually causes cell death.

Blood is critical for maintaining circulation, pH levels, adequate tissue oxygenation, and waste removal in the body. Hemorrhagic shock can cause death despite medical treatment due to heavy blood loss in a very short period of time—more than 30% of total blood volume—due to a combination of factors:

  • Coagulopathy (impaired blood clotting leading to excessive and prolonged blood loss)
  • Hypothermia (dangerous drop in body temperature)
  • Acidosis (high acid levels in the body)

Additionally, severe hemorrhage can trigger catastrophic multiorgan dysfunction by mechanisms that include:

  • Hypovolemic shock affecting tissue perfusion
  • Redistribution of blood from organs such as the intestines, liver, and kidneys to the brain, heart, and lungs, which causes dysfunctional changes
  • Proinflammatory state due to release of tumor necrosis factor alpha and C-reactive protein, which speeds up coagulopathy

What are different types of hemorrhage?

Hemorrhage is defined as loss of blood from a damaged blood vessel. Hemorrhages can be:

  • Internal (invisible blood loss): Due to injury to an internal organ
  • External (visible blood loss): Due to a cut, wound, or bruise

Different types of hemorrhage include:

  • Intracranial hemorrhage: Bleeding inside the brain
  • Intracerebral hemorrhage: Bleeding within the brain tissues
  • Subarachnoid hemorrhage: Injury to blood vessels of the brain caused by head trauma
  • Subconjunctival hemorrhage: Damage to the blood vessels of the eye
  • Subdural hematoma: Blood leak into the dura mater (a membrane between the brain and skull)
  • Postpartum hemorrhage: Heavy bleeding after childbirth
  • Epistaxis: Bleeding from the nostril, nasal cavity or nasopharynx
  • Hematoma: Collection of blood outside the blood vessel (bruise)
  • Hemothorax: Collection of blood between the chest wall and the lungs
  • Petechiae: Tiny, pinpoint red or purple spots on the skin

What are the symptoms of hemorrhage?

Symptoms vary depending on the location and severity of hemorrhage.

In cases of a minor bruise or trauma, there may be light bleeding along with mild pain and discomfort. However, heavy blood loss can lead to:

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What causes hemorrhage?

Normally with an injury, the body initiates a clotting process to stop the bleeding. Clotting requires proteins in the blood and platelets which combine to form a plug and seal the inside of the wound, thus preventing excessive bleeding. However, significant injuries often cannot be stopped by a clot. Certain medical conditions can also interfere with the clotting process.

Potential causes of hemorrhage include:

How is hemorrhage diagnosed?

Diagnosis is made based on:

  • Physical examination in which symptoms are evaluated based on the accident or trauma, existing medical conditions, and current medications taken
  • Electroencephalogram (EEG) to record the electrical activity of the brain
  • Computed tomography scan and magnetic resonance imaging scan to determine the cause, location, and extent of internal hemorrhage
  • Urine test
  • Blood test
  • X-ray chest

How is hemorrhage treated?

Treatment of hemorrhage depends on:

  • Location of the hemorrhage 
  • Severity of the hemorrhage
  • Amount of blood loss
  • General condition of the patient

External bleeding can be treated with first aid such as:

  • Applying pressure on the wound by using hands, a clean cloth, or bandage
  • Wrapping a clean, dry cloth on the wound
  • Tying a cloth or band (tourniquet) proximal to the wound, toward the heart, to stop the bleeding

Seek immediate medical help if the bleeding doesn't stop or the person has the following signs:

Treatment may consist of:

  • Intravenous administration of blood or blood products (fresh frozen plasma or platelets)
  • Intravenous electrolytes
  • Surgery to repair the damaged blood vessel or to remove the clotted blood
  • Medications to promote clotting

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What are complications of hemorrhage?

Complications of hemorrhage include:

  • Infections
  • Ischemic stroke (obstruction of the artery supplying blood to the brain)
  • Myocardial infarction
  • Hemorrhagic shock
  • Coma
  • Sepsis (life-threatening response to infection that can lead to tissue damage and organ failure)
  • Multiorgan failure
  • Death

Can hemorrhage be prevented?

Lifestyle modifications can prevent the recurrence of hemorrhage:

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Medically Reviewed on 2/9/2022
References
Image Source: iStock Images

Hemorrhage. Cleveland Clinic: https://my.clevelandclinic.org/health/symptoms/21654-hemorrhage

Christopher Melinosky. Brain Hemorrhage. WebMD: https://www.webmd.com/brain/brain-hemorrhage-bleeding-causes-symptoms-treatments