Learn About Hypovolemic Shock

What is the definition of Hypovolemic Shock?

Hypovolemic shock is an emergency condition in which severe blood or other fluid loss makes the heart unable to pump enough blood to the body. This type of shock can cause many organs to stop working.

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What are the alternative names for Hypovolemic Shock?

Shock - hypovolemic

What are the causes of Hypovolemic Shock?

Losing about one fifth or more of the normal amount of blood in your body causes hypovolemic shock.

Blood loss can be due to:

  • Bleeding from cuts
  • Bleeding from other injuries
  • Internal bleeding, such as in the gastrointestinal tract

The amount of circulating blood in your body also may drop when you lose too much body fluid from other causes. This can be due to:

  • Burns
  • Diarrhea
  • Excessive perspiration
  • Vomiting
What are the symptoms of Hypovolemic Shock?

Symptoms may include:

  • Anxiety or agitation
  • Cool, clammy skin
  • Confusion
  • Decreased or no urine output
  • Generalized weakness
  • Pale skin color (pallor)
  • Rapid breathing
  • Sweating, moist skin
  • Unconsciousness (lack of responsiveness)

The greater and more rapid the blood loss, the more severe the symptoms of shock.

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What are the current treatments for Hypovolemic Shock?

Get medical help right away. In the meantime, follow these steps:

  • Keep the person comfortable and warm (to avoid hypothermia).
  • Have the person lie flat with the feet lifted about 12 inches (30 centimeters) to increase circulation. However, if the person has a head, neck, back, or leg injury, do not change the person's position unless they are in immediate danger.
  • Do not give fluids by mouth.
  • If person is having an allergic reaction, treat the allergic reaction, if you know how.
  • If the person must be carried, try to keep them flat, with the head down and feet lifted. Stabilize the head and neck before moving a person with a suspected spinal injury.

The goal of hospital treatment is to replace blood and fluids. An intravenous (IV) line will be put into the person's arm to allow blood, blood products, or fluids to be given.

Medicines such as epinephrine or norepinephrine may be needed to increase blood pressure and the amount of blood pumped out of the heart (cardiac output).

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What is the outlook (prognosis) for Hypovolemic Shock?

Symptoms and outcomes can vary, depending on:

  • Amount of blood/fluid volume lost
  • Rate of blood/fluid loss
  • Illness or injury causing the loss
  • Underlying chronic medical conditions, such as diabetes and heart, lung, and kidney disease, or related to injury

In general, people with milder degrees of shock tend to do better than those with more severe shock. Severe hypovolemic shock may lead to death, even with immediate medical attention. Older adults are more likely to have poor outcomes from shock.

What are the possible complications of Hypovolemic Shock?

Complications may include:

  • Kidney damage (may require temporary or permanent use of a kidney dialysis machine)
  • Brain damage
  • Gangrene of arms or legs, sometimes leading to amputation
  • Heart attack
  • Other organ damage
  • Death
When should I contact a medical professional for Hypovolemic Shock?

Hypovolemic shock is a medical emergency. Call the local emergency number (such as 911) or take the person to the emergency room.

How do I prevent Hypovolemic Shock?

Preventing shock is easier than trying to treat it once it happens. Quickly treating the cause will reduce the risk of developing severe shock. Early first aid can help control shock.

What are the latest Hypovolemic Shock Clinical Trials?
HIGH-dose Intravenous VItamin C in Patients With Septic Shock: HIGH-VIS Trial
Summary: Despite promising observational and phase 1 data, the therapeutic potential of vitamin C for the management of septic shock has not borne out in recent large multi-centre randomized controlled trials. There is biological plausibility for benefit with intravenous vitamin C, and the investigators hypothesize that the doses used in these trials were insufficient to demonstrate an effect. High-dose vi...
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A Randomized, Double-Blind, Placebo Controlled Dose-Ranging Study of Auxora in Patients With Acute Pancreatitis and Accompanying Systemic Inflammatory Response Syndrome
Summary: Approximately 216 patients with acute pancreatitis and accompanying SIRS will be randomized at approximately 30 sites. Patients will be randomly assigned to either Auxora at one of three dose levels or one of three placebo volumes to maintain the double-blind. Study drug infusions will occur every 24 hours for three consecutive days for a total of three infusions. Patients will remain hospitalized...
What are the Latest Advances for Hypovolemic Shock?
Predictors of response to intra-arterial vasodilatory therapy of non-occlusive mesenteric ischemia in patients with severe shock: results from a prospective observational study.
Summary: Predictors of response to intra-arterial vasodilatory therapy of non-occlusive mesenteric ischemia in patients with severe shock: results from a prospective observational study.
Tranexamic acid is not inferior to placebo with respect to adverse events in suspected traumatic brain injury patients not in shock with a normal head computed tomography scan: A retrospective study of a randomized trial.
Summary: Tranexamic acid is not inferior to placebo with respect to adverse events in suspected traumatic brain injury patients not in shock with a normal head computed tomography scan: A retrospective study of a randomized trial.
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Early application of extracorporeal membrane oxygenation for myocarditis with shock: a case report.
Summary: Early application of extracorporeal membrane oxygenation for myocarditis with shock: a case report.
Who are the sources who wrote this article ?

Published Date: November 13, 2021
Published By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Angus DC. Approach to the patient with shock. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 98.

Dries DJ. Hypovolemia and traumatic shock: nonsurgical management. In: Parrillo JE, Dellinger RP, eds. Critical Care Medicine: Principles of Diagnosis and Management in the Adult. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 26.

Maiden MJ, Peake SL. Overview of shock. In: Bersten AD, Handy JM, eds. Oh's Intensive Care Manual. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 15.

Puskarich MA, Jones AE. Shock. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 6.