Possible Causes for decreased plasma volume Anemia In individuals with iron-deficiency anemia, a decrease in plasma iron levels occurs, limiting erythropoiesis. [ncbi.nlm.nih.gov] (PCV), red cell folate (decreased in AD), erythrocyte sedimentation rate (ESR) and haptoglobin (increased in AD), with a trend of decreased plasma iron in AD (Table 1). [nature.com] It occurs as a result of chronic blood loss, urinary losses, poor iron intake/absorption, and increased blood volume. [ncbi.nlm.nih.gov] Hypovolemia Broadly defined, hypovolemia represents inadequate circulating plasma volume leading to decreased cardiac preload and thus decreased cardiac output and blood pressure. [oxfordmedicine.com] Abnormally decreased volume of circulating fluid (plasma) in the body An abnormally low volume of blood circulating through the body. [icd9data.com] « Back to Glossary Index Hypovolemia is a decrease in blood volume, more accurately a decrease in plasma volume. Hypovolemia is also know as oligemia or shock. [secondchanceaihadogs.com] Therapeutic Phlebotomy Relative polycythaemia explained The decrease in plasma volume that causes an increase in the mass of red blood cells characterizes relative polycythaemia. [ephlebotomytraining.com] Relative polycythaemia is characterised by a decrease in plasma volume which causes an apparent increase in the red blood cell mass. [ncbi.nlm.nih.gov] It is comes in two types: absolute polycythaemia or relative polycythaemia that are defined as increase in the number of red blood cells and decrease in the plasma volume, [ephlebotomytraining.com] Addison Disease Cortisol and aldosterone deficiency together cause changes in blood levels of sodium and potassium and a decrease in plasma volume, which can lead to extreme dehydration and [lifeextension.com] Urinary salt and water loss cause severe dehydration, plasma hypertonicity, acidosis, decreased circulatory volume, hypotension, and, eventually, circulatory collapse. [merckmanuals.com] Stress Polycythemia plasma volume. [lifeinthefastlane.com] Since the Hct is a ratio between the number of circulating RBCs per unit volume of whole blood, an elevated Hct may be caused by a decreased plasma volume. [163.178.103.176] It results from decreasing plasma volume and subsequent hemoconcentration. [doctor-clinic.org] Acute Hemorrhage A 28-year-old renal transplant patient developed a shock due to an acute bleeding from his right native kidney. An urgent nephrectomy was performed. Macroscopic and histological examination revealed a pyelocaliceal diverticulum as the cause of the hemorrhage. This rare event must be taken into account in every[…] [ncbi.nlm.nih.gov] Gaisbock's Syndrome The red cell volume is normal but, as a result of decreased plasma volume there is relative polycythaemia. [babylon-software.com] Relative/pseudo polycythaemia occurs due to decreased plasma volume. [mrcpandme.blogspot.com] Secondary Polycythemia Plasma loss in burn and enteropathy. This is characterized by : Raised hemoglobin. Normal TLC. Normal platelets. Normal red cell mass. Decreased plasma volume. [labpedia.net] Relative polycythemia, or erythrocythemia, results from decreased plasma volume. A true polycythemia or erythrocythemia results from increased red blood cell mass. [emedicine.medscape.com] There is pseudopolycythemia where red cell volume is normal but the plasma volume is reduced. [labpedia.net] Essential Hypertension Plasma volume was diminished in hypertensive men. [nejm.org] Plasma volume tends to decrease as BP increases; rarely, plasma volume remains normal or increases. [merckmanuals.com] This decrease was greater the higher the diastolic pressure (r equal to -0.434; p less than 0.01), so that it was only evident in the patients with diastolic blood pressures [nejm.org] Hypertension Plasma volume tends to decrease as BP increases; rarely, plasma volume remains normal or increases. [msdmanuals.com] Plasma volume tends to be high in hypertension due to primary aldosteronism or renal parenchymal disease and may be quite low in hypertension due to pheochromocytoma. [msdmanuals.com] Patients with high, fixed diastolic pressures often have decreased CO. [msdmanuals.com] Haemoconcentration […] haemoconcentration n. an increase in the proportion of red blood cells relative to the plasma, brought about by a decrease in the volume of plasma or an increase in the concentration [medicine.academic.ru] volume (polycythemia vera, secondary polycythemia) and decreased plasma volume and constant number of erythrocytes (stress-polycythemia). [longdom.org] Also found in: Dictionary, Encyclopedia. haemoconcentration he·mo·con·cen·tra·tion ( hē'mō-kon'sĕn-trā'shŭn ) Decrease in the volume of plasma in relation to the number of [medical-dictionary.thefreedictionary.com] Hyponatremia plasma volume and increased serum osmolality 2 Secretion of vasopressin is normally stimulated by increased plasma osmolality via activation of osmoreceptors in the anterior [samsca.com] For example, decreased effective plasma volume may occur with decreased ECF volume (as with diuretic use or hemorrhagic shock), but it may also occur with an increased ECF [merckmanuals.com] […] hypothalamus and by decreased blood volume or pressure via activation of baroreceptors in the carotid sinus, aortic arch, cardiac atria, and pulmonary venous system. 1,3 [samsca.com] Polycythemia Plasma loss in burn and enteropathy. This is characterized by : Raised hemoglobin. Normal TLC. Normal platelets. Normal red cell mass. Decreased plasma volume. [labpedia.net] plasma volume. [litfl.com] Isotope dilution techniques to determine the red cell mass and plasma volume can differentiate true erythrocytosis from a spurious elevation due to a decrease in plasma volume [mdedge.com] Puerperium Diuresis further decreases plasma volume in the first days, although as interstitial fluid is mobilized subsequently the plasma volume tends to increase transiently causing [doctorlib.info] Women can lose about 1000 mL of their predelivery blood volume before postnatal haemoglobin concentration is compromised (Letsky, 1998; Case study 14.2). [doctorlib.info] Orthostatic Hypotension volume and decreasing venous pooling. [healio.com] volume to decrease 300 to 500 mL. 4 The effect of chronic hypertension on cerebral autoregulation also contributes to symptoms of orthostatic hypotension. [consultant360.com] The plasma volume, by contrast, was decreased (less than 30 ml per kilogram) in only one patient5. [nejm.org] Morbid Obesity […] cardiac failure Volume of distribution Decreased fraction of total body water Increased adipose tissue Increased lean body mass Altered tissue protein binding Increased blood [academic.oup.com] […] free fatty acids, cholesterol, α 1 acid glycoprotein Organomegaly Plasma protein binding Adsorption of lipophilic drugs to lipoproteins so increased free drug available Plasma [academic.oup.com] […] albumin unchanged Increased α 1 -acid glycoprotein Drug clearance Increased renal blood flow Increased GFR Increased tubular secretion Decreased hepatic blood flow in congestive [academic.oup.com] Ileus Progressive volume depletion leads to decreased glomerular filtration rate and greater retention of glucose and ketoanions in plasma. [care.diabetesjournals.org] TREATMENT Therapeutic goals The therapeutic goals for treatment of hyperglycemic crises in diabetes consist of 1 ) improving circulatory volume and tissue perfusion, 2 ) decreasing [care.diabetesjournals.org] […] serum glucose and plasma osmolality toward normal levels, 3 ) clearing the serum and urine of ketones at a steady rate, 4 ) correcting electrolyte imbalances, and 5 ) identifying [care.diabetesjournals.org] Diabetes Mellitus This decreases plasma volume, thus lowering the glomerular filtration rate and enhancing the absorption of sodium and water in the proximal nephron. [en.wikipedia.org] […] in plasma volume. 63 In this sense, it has been demonstrated that troglitazone produces water retention, which causes hemodilution and edema due to a vasodilator effect. [revespcardiol.org] It seems paradoxical to treat an extreme diuresis with a diuretic, and the exact mechanism of action is unknown but the thiazide diuretics will decrease distal convoluted [en.wikipedia.org] Preeclampsia plasma volume or ischemic acute tubular necrosis) New-onset hypertension (blood pressure [BP] 140/90 mm Hg) plus new unexplained proteinuria ( 300 mg/24 hours after 20 weeks [msdmanuals.com] plasma volume or ischemic acute tubular necrosis) New-onset hypertension (BP 140/90 mm Hg) plus new unexplained proteinuria ( 300 mg/24 h after 20 wk or a urine protein/creatinine [merckmanuals.com] Dyspnea (reflecting pulmonary edema, acute respiratory distress syndrome [ARDS], or cardiac dysfunction secondary to increased afterload) Stroke (rarely) Oliguria (reflecting decreased [msdmanuals.com] Delirium Plasma protein, particularly albumin, is altered with aging. [pmj.bmj.com] Albumin is often decreased, and α1-acid glycoprotein is increased, especially during an inflammatory illness.34 In delirium plasma albumin drops precipitously; conversely [pmj.bmj.com] […] often overestimates the actual renal function, due to age related reduction in creatinine, which is secondary to reduced lean body mass.33 Protein binding also determines volume [pmj.bmj.com] Hyperkalemia Vasodilatation leads to a decreased effective arterial blood volume and activation of neurohumoral systems such as RAAS. [hindawi.com] At the same time, HF patients present increased levels of plasma aldosterone leading to increased sodium reabsorption in the proximal nephron and its decreased delivery to [karger.com] Increased plasma antidiuretic hormone (ADH) levels lead to water and sodium retention causing ascites and dilution hyponatremia further [4]. [hindawi.com] Renal Function Impairment volume as a result of the infection. 10,12 We conducted a study to determine whether plasma volume expansion with albumin could prevent the impairment of renal function and [nejm.org] […] and ascitic fluid 10 and is associated with marked activation of the renin–angiotensin system. 10 It is considered to be caused by a decrease in effective arterial blood [nejm.org] […] deterioration of renal function is the most sensitive predictor of in-hospital mortality. 12 Renal impairment occurs in patients with the highest concentrations of cytokines in plasma [nejm.org] Postural Orthostatic Tachycardia Syndrome A variety of mechanisms have been proposed, and more than one may coexist in these patients ( 1 ): Hypovolemia: 70% of patients have a decreased plasma volume without a compensatory [unboundmedicine.com] […] in volume of blood plasma. [1] The two are regulated through independent mechanisms in humans; [1] the distinction is important in guiding treatment. [11] Prevention [ edit [en.wikipedia.org] There is a secondary shift of plasma volume (10% to 25%) out of the vasculature and into the interstitial tissue, which decreases venous return to the heart (preload), resulting [ahajournals.org] Cerebral Salt-Wasting Syndrome Patients with CSWS have decreased plasma volume, decreased extracellular fluid, and primary hyponatremia. [journals.lww.com] Another cause of hyponatremia results from decreased effective plasma volume (decreased oncotic pressure). [clinicaladvisor.com] Further, increased plasma volume is sensed at the level of the kidney’s juxta-glomerular apparatus, which decreases secretion of renin, inhibiting the renin-angiotensin-aldosterone [docneuro.com] Acidosis […] by 0.3 units for every two-fold change in plasma [H ] 11 The urine volume is dependent on the number of urinary solutes and their concentration in the urine when vasopressin [academic.oup.com] […] while the other remained unchanged, the [H ] would also increase or decrease by a factor of two In pH terms, because log 2 0.301, this means that the pH will increase or decrease [academic.oup.com] Proteus volume, possibly leading to decrease in placental perfusion. [webmedcentral.com] […] associates [54] include: Generally, the use of diuretics should be discouraged because of the theoretical risk that they would impair the normal pregnancy-associated expansion of plasma [webmedcentral.com] Heart Failure Diuretics increase the urine volume by enhancing the excretion of water, sodium chloride and other ions, leading to a decrease in plasma and extracellular fluid volume, total [doi.org] plasma norepinephrine concentrations by 50% and decreased preload and increased stroke volume significantly. 79 However, both bradycardia and atrioventricular dissociation [doi.org] Although there are commonalities in the neurohormonal responses to decreased stroke volume, the neurohormone-mediated events that follow have been most clearly elucidated [emedicine.com] Congestive Heart Failure Diuretics increase the urine volume by enhancing the excretion of water, sodium chloride and other ions, leading to a decrease in plasma and extracellular fluid volume, total [doi.org] plasma norepinephrine concentrations by 50% and decreased preload and increased stroke volume significantly. 79 However, both bradycardia and atrioventricular dissociation [doi.org] Although there are commonalities in the neurohormonal responses to decreased stroke volume, the neurohormone-mediated events that follow have been most clearly elucidated [emedicine.com] Pulmonary Edema Patients with severe BCS have been reported to have an expanded plasma volume. [ncbi.nlm.nih.gov] Causes: Increased hydrostatic pressure Increased capillary permeability Decreased plasma oncotic Pressure Insufficient lymphatic drainage Failure of the fluid balance system [media.lanecc.edu] In addition, pneumoperitoneum during laparoscopic surgery has been reported to decrease the venous flow in the portal vein and/or renal vein, the collateral pathways in BCS [ncbi.nlm.nih.gov] Burn Injury Decreased plasma volume, increased afterload and decreased cardiac contractility cause a decrease in cardiac output. [medictests.com]
