University:
Michigan State University
Course:
MED 609 | Hematology Clerkship
Academic year:

2020
Views:

320

Pages:

22
Author:

Dixie Summers

Hypovolemic Shock Definition • Shock, or acute circulatory failure a state in which the delivery of oxygen and nutrients to the tissue is insufficient to meet basal metabolic needs, leading to tissue hypoxia, and, if persistent, to MOF and death. Hypovolaemic shock • Hypovolaemic shock is characterized by a profound reduction in blood volume. • It is the most common source of shock • Can easily be reversed, if detected early and provided its cause can be corrected. Causes • Bleeding Trauma Digestive haemorrhage Decreased plasma volume diarrhoea vomiting Compensatory mechanisms Hormonal: Renin-angiotension system • Decrease renal perfusion • Releases renin angiotension I - • angiotension II → potent vasoconstriction • releases aldosterone adrenal cortex • sodium & water retention Compensatory mechanisms Hormonal: Antidiuretic Hormone Osmoreceptors in hypothalamus stimulated • ADH released by Posterior pituitary gland • Vasopressor effect to increase BP • Acts on renal tubules to retain water Stages of Shock Initial stage - tissues are under perfused, decreased CO, increased anaerobic metabolism, lactic acid is building Compensatory stage - Reversible. SNS activated by low CO, attempting to compensate for the decrease tissue perfusion. Progressive stage - Failing compensatory mechanisms: profound vasoconstriction from the SNS Lactic acid production is high ISCHEMIA metabolic acidosis Irreversible or refractory stage - Cellular necrosis and Multiple Organ Dysfunction Syndrome may occur . • Net results of cellular shock: • systemic lactic acidosis • decreased myocardial contractility • decreased vascular tone • decrease blood pressure, preload, and cardiac output

Hypovolemic Shock

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