Hypovolemia
The content of the article:
- Causes
- Kinds
- Signs
- Diagnostics
- Treatment
- Prevention
- Consequences and complications
Hypovolemia is a pathological condition manifested by a decrease in the volume of circulating blood, in some cases accompanied by a violation of the ratio between plasma and formed elements (erythrocytes, platelets, leukocytes).
For information, in normal adult women, the total blood volume is 58–64 ml per 1 kg of body weight, in men - 65–75 ml / kg.
With hypovolemia, the volume of circulating blood decreases
Causes
Lead to the development of hypovolemia:
- acute blood loss;
- significant loss of fluid by the body (with burns of a large area, diarrhea, indomitable vomiting, polyuria);
- vasodilation collapse (a sharp expansion of blood vessels, as a result of which their volume ceases to correspond to the volume of circulating blood);
- shock conditions;
- insufficient intake of fluid in the body with increased losses (for example, at high ambient temperatures).
Kinds
Depending on the hematocrit (an indicator of the ratio of blood and plasma corpuscles), the following types of hypovolemia are distinguished:
- Normocythemic. It is characterized by a general decrease in blood volume while maintaining the ratio of plasma and corpuscles (hematocrit is within normal limits).
- Oligocythemic. The content of blood corpuscles mainly decreases (the hematocrit value decreases).
- Polycythemic. To a greater extent, there is a decrease in plasma volume (hematocrit is above normal).
The most severe manifestation of hypovolemia is called hypovolemic shock.
Signs
The clinical manifestations of hypovolemia are determined by its type.
The main symptoms of normocythemic hypovolemia:
- weakness;
- dizziness;
- lowering blood pressure;
- tachycardia;
- weak pulse jerk;
- decreased urine output;
- cyanosis of mucous membranes and skin;
- decrease in body temperature;
- fainting;
- muscle cramps of the lower extremities.
Oligocythemic hypovolemia is characterized by signs of impaired blood supply to organs and tissues, a decrease in the oxygen capacity of the blood, and increasing hypoxia.
Dizziness and weakness are characteristic of hypovolemia.
Signs of polycythemic hypovolemia:
- significant increase in blood viscosity;
- severe disorders of microcirculatory circulation;
- disseminated microthrombosis; and etc.
Hypovolemic shock is manifested by a pronounced clinical picture, a rapid increase in symptoms.
Diagnostics
The diagnosis and degree of hypovolemia is based on clinical symptoms.
The volume of laboratory and instrumental studies depends on the nature of the pathology that led to a decrease in the volume of circulating blood. The mandatory minimum includes:
- determination of hematocrit;
- general blood analysis;
- blood biochemistry;
- general urine analysis;
- determination of blood group and Rh factor.
To diagnose hypovolemia, hematocrit is determined and other laboratory and instrumental studies are performed
If hypovolemia caused by bleeding into the abdominal cavity is suspected, diagnostic laparoscopy is performed.
Treatment
The goal of therapy is to restore normal circulating blood volume as soon as possible. For this, dextrose solutions, physiological saline and polyionic solutions are infused. In the absence of a persistent effect, intravenous administration of artificial plasma substitutes (solutions of hydroxyethyl starch, gelatin, dextran) is indicated.
In parallel, the therapy of the underlying pathology is carried out to prevent an increase in the severity of hypovolemia. So, if there is a source of bleeding, surgical hemostasis is performed. If a decrease in the volume of circulating blood is due to a shock state, appropriate anti-shock therapy is prescribed.
For the treatment of hypovolemia, the introduction of artificial plasma substitutes is indicated
In the serious condition of the patient and the appearance of signs of respiratory failure, the question of the advisability of intubation of the trachea and the transfer of the patient to artificial ventilation is decided.
Prevention
Prevention of hypovolemia includes:
- prevention of injuries;
- timely treatment of acute intestinal infections;
- sufficient intake of water into the body, correction of the water regime under changing environmental conditions;
- refusal of self-medication with diuretics.
Consequences and complications
In the absence of emergency therapy, severe hypovolemia ends in the development of hypovolemic shock, a life-threatening condition. In addition, against the background of a decrease in the volume of circulating blood, functional insufficiency of a number of internal organs (brain, kidneys, liver) may occur.
Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
