Hypovolemic Shock
It occurs due to loss of blood plasma or body fluid and electrolytes, usually caused by massive hemorrhage, vomiting,diarrhea and dehydration.
Hypovolemic shock is most common type of shock which is characterized by loss in circulatory volume which leads to decrease in venous return, decrease in filing of cardiac chambers, so there is decreased in cardiac output which causes increase in systemic vascular resistance.
Types Of Hypovolemia
- Covert-compensated hypovolemia (Mild <15%): When blood volume is reduced by 10–15%, there will not be signifiant change in heart rate, cardiac output and splanchnic blood compensates for the same.
“Risk Factors For Developing Hypovolemic Shock”
- Overt compensated hypovolemia (Moderate 15–40%): Here patient has cold periphery, tachycardia, a wide arterial pressure, tachypnea, confusion, hyponatremia, metabolic acidosis, but systolic pressure is well—maintained but postural hypotension.
- Decompensated hypovolemia (Severe >40%): Here all features of hypovolemia are present like hypotension, tachycardia, sweating, tachypnea, oliguria, drowsiness, and eventually features of systemic inflammatory response syndrome is seen, and often if not treated on time leads to multiorgan dysfunction syndrome, i.e. irreversible shock
“Causes Of Hypovolemic Shock In Adults”
Hypovolemic Shock Causes
Loss of extracellular fluid:
- Deviation of normal exchange pattrn: As in vomiting,diarrhea, intestinal obstruction, peritonitis, and acute pancreatitis.
- Increased sweating without replacement in a non acclimatized individual.
- Third space shift to sodium from extracellular to intracellular compartment due to failure of sodium pump caused by hypoxia.
Plasma loss: Due to burn.
Hemorrhage: Due to whole blood loss like.
- Surgical: During and following any major surgery especially cardiopulmonary bypass, pelvic surgery or major abdominal surgery.
- Traumatic: As a result of any type of major accident, warfare injuries, homicidal or following suicidal injury as by knife, bullet, etc.
- GI bleeding: Bleeding from peptic ulcer, perforation of intestine, bleeding from esophageal varices, etc.
- Obstructive bleeding: Incomplete abortion, placenta previa, etc.
“Symptoms Of Hypovolemic Shock”
Hypovolemic Shock Clinical Features
- Anxiety, restless, excitation and disorientation.
- Pallor
- Thirst and hunger
- Cold and clammy skin
- Faint in upright position
- Tachycardia with rapid, thready pulse
- Hypotension
- Oligouria or anuria.
“The Role Of Fluid Resuscitation In Treating Hypovolemic Shock”
Hypovolemic Shock Management
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