Symptoms include :
Other signs may be:
Work up consists of a detailed history and physical examination.
The cause of bleeding should be immediately identified and treated. Treatment could be surgical or via medications, depending upon the cause.
Treatment of burns
Treating other underlying cause
If the cause of hypovolemia is due to a pregnancy-associated condition, or due to gastrointestinal disturbances or disease, or due to any other cause, that underlying cause should be identified and promptly treated.
Many fluids have been studied for use in resuscitation; these include isotonic sodium chloride solution, lactated Ringer solution , FFP, hypertonic saline, dextran 70, albumen, etc. The loss of blood volume should be recompensed with appropriate fluids to avoid systemic effects.
Emergency oxygen should be immediately employed to increase the efficiency of the patient's remaining blood supply. This intervention can be life saving .
Blood should be matched and transfusions should be performed to replace the lost blood volume.
Vasopressers and thrombogenic drugs may be administered if needed, to prevent further episodes of bleeding.
Prognosis depends upon how early treatment is begun. If patients are brought to the emergency and treated accordingly, prognosis is excellent. However, if the hypovolemia has extended to multiorgan failure, death may ensue.
Possible complications include the following:
Hypovolemic shock results from low cardiac output due to the loss of blood or plasma volume, such as can occur with massive hemorrhage or fluid loss from severe burns . Hemorrhage is the most common cause of hypovolemic shock.
Less common causes include plasma loss in severe burns, or into the abdominal cavity in acute pancreatitis, inappropriate vasodilatation in bacteraemic shock and anaphylactic shock, and excess urinary fluid loss as in diabetic ketoacidosis .
Excessive diarrhea and severe vomiting may also cause hypovolemic shock. Pregnancy associated conditions such as ectopic pregnancy rupture or placenta previa may cause hypovolemia, and so can arteriovenous malformations, gastrointestinal disturbances such as Mallory-Weiss tears, esophageal varices and peptic ulcers.
It has no known gender prevalence.
Hypovolemic shock may occur at any age, depending upon the underlying etiology. It may occur in young children who have suffered severe burns or it may occur in adults who have had a serious accident leading to heavy blood loss.
As discussed in the previous section, the commonest cause of hypovolemia is hemorrhage. Hemorrhage decreases the filling pressure of the circulation and, as a consequence, decreases venous return. As a result, the cardiac output falls below normal and shock may ensue . Hypovolemia occurs so commonly due to hemorrhage that the term hypovolemic shock is sometimes used interchangeably with hemorrhagic shock.
The severity of hypovolemia can be staged. The stages include the following:
Shock is characterised by systemic hypotension due either to reduced cardiac output or to reduced effective circulating blood volume . Hypovolemic shock occurs due to a rapid fall in blood volume resulting in life threatening hypotension and may lead to multi organ failure, and ultimately, death.
Common causes of hypovolemia are :
Symptoms and signs may include:
Diagnosis is made by evaluating a combination of factors like history, physical examination and laboratory tests.
Treatment includes fluid replacement, blood transfusions, oxygen and sometimes, surgical repair.
Hypovolemic shock can be prevented by giving first aid on development of symptoms and admitting the patient to a hospital as soon as possible.