PATHOPHYSIOLOGY OF HYPOVOLEMIC SHOCK

Risk Factors:
Non- Modifiable
CIRCULATORY Modifiable such as:
SYSTEM Fluid Losses: Internal Losses:
- trauma - hemorrhage
- surgery - burns
- vomiting - ascites
- diarrhea - peritonitis
ETIOLOGY/CAUSE: - diuresis - dehydration
Loss of Blood Volume - diabetis
external blood loss Insipidus/mellitus
internal blood loss
Loss of plasma Volume
GI losses
Renal losses
Transcutaneous Losses
Internal losses (a.k.a. third-spacing)

↓ Intravascular Volume ↓ Cardiac Output

Compensatory Mechanisms

Molecular Changes:
Gross/Anatomical Physical
Changes:
Kidneys releases Aldosterone
ADH ( posterior pituary gland )
↑ Sodium/water retention
Cathecholamine released by the Adrenal
↑ Heart Rate/Contractility
Gland (norepinephrine,adrenaline,
↑ Volume
dopamine)
↑ Cardiac Volume
- ↑ SVR
↓ tissue perfusion
↑ Oxygen requirement
↓ BP
↑ Oxygen demand
Splenic discharge-
( disgorging stored RBC and Plasma )

- if compensation fails
- great losses
 Complications: Clinical
Pathophysiologic
Manifestations
HYPOVOLEMIC Manifestation
( S/S ) :SHOCKon Laboratory Exams:
Effect on Bodily Function:
• Multiple Organ • poor skin turgor • CBC
Failure • • ↓ cardiac output
thirst • CT Scan or X-Ray of
• Death • • ↓ cardiac ejection
oliguria suspected area
• • ↓ impaired
thready pulse cellular metabolism • Endoscopy
• ↓ BP
• cool clammy skin • Echocardiogram
• Right Heart Catheterization
• weakness
( Swan-Ganz)
• pale skin
• Urine Specific Gravity
• mental status
deterioration (mental
confusion/loss of

• If Compensatory Failed
• Great losses took place