PATHOPHYSIOLOGY OF HYPOVOLEMIC SHOCK

CIRCULATORY SYSTEM

ETIOLOGY/CAUSE: Loss of Blood Volume external blood loss internal blood loss Loss of plasma Volume GI losses Renal losses Transcutaneous Losses Internal losses (a.k.a. third-spacing)

Risk Factors: Non- Modifiable Modifiable such as: Fluid Losses: Internal Losses: - trauma - hemorrhage - surgery - burns - vomiting - ascites - diarrhea - peritonitis - diuresis - dehydration - diabetis Insipidus/mellitus

Intravascular Volume

Cardiac Output

Compensatory Mechanisms

Molecular Changes: Kidneys releases Aldosterone ADH ( posterior pituary gland ) Cathecholamine released by the Adrenal Gland (norepinephrine,adrenaline, dopamine) - SVR tissue perfusion Oxygen requirement BP Oxygen demand Splenic discharge( disgorging stored RBC and Plasma )

Gross/Anatomical Physical Changes: Sodium/water retention Heart Rate/Contractility Volume Cardiac Volume

if compensation fails great losses

Complications: Multiple Organ Failure Death

Clinical Manifestations Manifestation on Pathophysiologic ( S/S ) :SHOCK HYPOVOLEMIC Effect on Bodily Function: poor skin turgor thirst cardiac output cardiac ejection oliguria impaired thready pulse cellular metabolism cool BP skin clammy weakness pale skin mental status deterioration (mental confusion/loss of

Laboratory Exams: CBC CT Scan or X-Ray of suspected area Endoscopy Echocardiogram Right Heart Catheterization ( Swan-Ganz) Urine Specific Gravity

If Compensatory Failed Great losses took place