What is Hypovolemic Shock?

Hypovolemic shock, also known as hemorrhagic shock, is a serious and life-threatening medical condition which occurs when a person has lost more than 20% or one-fifth of the body’s blood or fluid. This severe loss of body fluids leads to a substantial decrease in the ability of the heart to pump sufficient amount of blood to the entire body. Hypovolemic shock also causes multiple organ failure and this condition requires prompt medical attention for the survival of the patient. Hypovolemic shock is thought to be the leading cause of death in individuals who have sustained traumatic injuries; injuries which will cause profuse loss of blood.
Treatment of Hypovolemic shock comprises of replacement of the lost blood/fluids, medications to increase the heart’s pumping ability.

Hypovolemic shock is a fatal condition caused by significant amount of blood/fluid loss from the body. Blood is responsible for carrying oxygen and other vital nutrients to the organs, tissues and rest of the body. Due to heavy blood loss, there is insufficient blood flow to the organs in your body; and when the blood is lost rapidly before it has been replaced, the organs are deprived of the important nutrients and oxygen; and they begin to shut down. As the heart starts to fail and doesn’t pump sufficient blood through the body, patient experiences symptoms of shock or Hypovolemic shock. This type of huge blood loss can occur from:

• Bleeding from traumatic injuries, such as from motor vehicle accidents can cause hypovolemic shock.
• Injuries from falls due to seizures.
• Internal bleeding in gastrointestinal tract or from an ectopic pregnancy which has ruptured also can cause hypovolemic shock.

Excessive loss of body fluids also cause decrease in blood volume leading to Hypovolemic Shock and this can occur in:

• Severe burns.
• Excessive diarrhea.
• Excessive and relentless vomiting.
• Excessive sweating.

The symptoms of hypovolemic shock differ according to the severity of the blood /fluid loss; but all the symptoms are of serious nature and should be treated immediately. Internal bleeding symptoms can be difficult to identify and the diagnosis is usually made after the symptoms of shock appear. However, symptoms from external bleeding will be visible, so steps can be taken to treat and prevent hypovolemic shock.

• Extremely low blood pressure is one of the signs in patients suffering from Hypovolemic shock.
• A significant drop in the body temperature, which is a life threatening situation.
• Feeling of anxiety.
• The lips and fingernails turn blue (cyanosis) in hypovolemic shock.
• Decreased or absence of urine output.
• Profuse sweating.
• In hypovolemic shock, there is rapid and shallow breathing.
• Dizziness and confusion.
• Rapid heart rate/palpitations.
• Weak/faint pulse
• Chest Pain
• In hypovolemic shock, there is loss of consciousness

• Pain in the abdomen
• Swelling in the abdomen.
• Chest pain.
• Blood in the urine (hematuria).
• Blood in the stool (hematochezia).
• Heavy vaginal bleeding, usually other than the normal menstruation.
• Vomiting blood (hematemesis).

The severity of the patient’s condition from the hypovolemic shock depends on the speed and the
amount of blood/fluid loss from the body. The extent of the injuries and the presence of other chronic medical conditions such as diabetes or lung, heart, kidney disease; all these conditions increase the chances of more complications from hypovolemic shock. Complications from hypovolemic shock occur as a result of huge loss of blood and fluids from the body and these complications are:

• Damage to major body organs like kidneys and brain.
• Occurrence of gangrene on arms or legs.
• Heart attack.

Patient experiences symptoms of hypovolemic shock after he/she is actually in the throes of this condition. A physical examination of the patient reveals the signs of hypovolemic shock, such as:

• Hypotension (low blood pressure).
• Tachycardia (rapid heartbeat).
• The patient is also disoriented and may not respond to the questions asked by the doctor.
• Internal bleeding is usually diagnosed only after patient shows signs of hypovolemic shock.

• Blood tests to assess kidney function and look for electrolyte imbalances.
• CT scan/ ultrasound to check for any damage to the body organs.
• Echocardiogram to check the heart rhythm.
• Right heart catheterization can be done to check the blood flow.
• Endoscopy for examining gastrointestinal organs.
• Urinary catheterization to calculate the quantity of urine present in the bladder.

• Treatment for hypovolemic shock focuses on replacing the lost fluids and blood.
• The patient suffering from hypovolemic shock is given lots of fluids and/or blood products intravenously.
• Medications which will increase the heart’s ability to pump, such as dopamine, epinephrine, can be given to patients suffering from Hypovolemic shock.
• Close monitoring of cardiac kidney function is done to assess the effectiveness of treatment.

Prognosis of hypovolemic shock depends on the amount and rate of blood/fluids loss, type of injury patient sustained and other medical conditions. Depending on that prognosis can be damage to important organs and death.

Some patients suffering from Hypovolemic shock can develop gangrene, as a result of decreased blood supply to the limbs; and this can result in amputation of the limbs which are affected.

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