Red blood cells (erythrocytes) have a short lifespan (approximately 120 days), and old (senescent) cells are constantly removed and replaced with new ones via erythropoiesis. This breakdown/replacement process is called erythrocyte turnover. In this sense, erythrolysis or hemolysis is a normal process that happens continually. However, these terms are usually used to indicate that the lysis is pathological. Complications
Pulmonary hypertension has been gaining recognition as a complication of chronic hereditary and acquired hemolysis. Free hemoglobin released during hemolysis inactivates the vasodilator nitric oxide (NO). Hemolysis also releases arginase that depletes L-arginine, the substrate needed for NO synthesis. This reduces NO-dependent vasodilation and induces platelet activation, thrombin generation, procoagulant factors and tissue factor activation, contributing to the formation of thrombosis. This can lead to esophageal spasm and dysphagia, abdominal pain, erectile dysfunction, systemic hypertension, decreased organ perfusion, promotion of inflammation and coagulation, and thrombosis.Chronic hemolysis may also lead to endothelial dysfunction, heightened endothelin-1-mediated responses and vasculopathy. The release of heme leads to the production of bilirubin and depletion of plasma proteins, such as albumin, haptoglobin, and hemopexin, which may lead to jaundice. It may also lead to increased levels of the heme breakdown product stercobilin in the stool.Splenectomy of those with hemolytic disorders appears to increase risk of developing pulmonary thrombosis.Complications may also arise from the increased workload for the kidney as it secretes erythropoietin to stimulate the bone marrow to produce more reticulocytes (red blood cell precursors) to compensate for the loss of red blood cells due to hemolysis.
After the blood collection process, in vitro hemolysis can still occur in a sample due to external factors, such as prolonged storage, incorrect storage conditions and excessive physical forces by dropping or vigorously mixing the tube. From mechanical blood processing during surgery
In some surgical procedures (especially some heart operations) where substantial blood loss is expected, machinery is used for intraoperative blood salvage. A centrifuge process takes blood from the patient, washes the red blood cells with normal saline, and returns them to the patients blood circulation. Hemolysis may occur if the centrifuge rotates too quickly (generally greater than 500 rpm)—essentially this is hemolysis occurring outside of the body. Increased hemolysis occurs with massive amounts of sudden blood loss, because the process of returning a patients cells must be done at a correspondingly higher speed to prevent hypotension, pH imbalance, and a number of other hemodynamic and blood level factors. Modeling of fluid flows to predict the likelihood of red cell membrane rupture in response to stress is an active area of research. From bacteria culture
Visualizing the physical appearance of hemolysis in cultured blood samples may be used as a tool to determine the species of various Gram-positive bacteria infections (e.g., Streptococcus). Nomenclature
Hemolysis is sometimes called hematolysis, erythrolysis, or erythrocytolysis. The words hemolysis () and hematolysis () both use combining forms conveying the idea of "lysis of blood" (hemo- or hemato- + -lysis). The words erythrolysis () and erythrocytolysis () both use combining forms conveying the idea of "lysis of erythrocytes" (erythro- ± cyto- + -lysis).