Hypovolemia

Hypovolemia (from the French volume - an unambiguous concept that defines stretching and volume) is a decrease in vascular tone that occurs with massive plasma and blood loss or a decrease in vascular tone due to disturbances in neuroreflex regulation.

In the latter case, the BCC does not change, but there is a redistribution of blood, mainly with overflow of the venous bed. Hypovolemia is characteristic of cardiovascular insufficiency, pathology and brain injury, pain syndrome, stress. The main manifestations are: hyperosmolarity of the blood, its thickening, decreased blood fluidity, hypoxia caused by decreased blood flow in organs and tissues, primarily the heart (low output syndrome) and the brain (impaired consciousness, seizures).

Hypovolemia accompanies many pathological conditions and is the leading component of shocks. With hypovolemia, the protein portion of plasma is not necessarily lost; this is more often observed with thermal trauma. In most cases, hypovolemia is accompanied by the loss of water and salts in edema, intestines, with urine, sweat, and breathing.

In this case, isoosmolar dehydration develops: BCC, BP, CVP decrease. Due to the decrease in blood flow to the right atrium, despite tachycardia, the cardiac output decreases with impaired peripheral blood flow and the development of hypoxic syndrome, mainly with acidosis. Clinically, apathy, adynamia, thirst, decreased turgor and dry skin are noted, diuresis decreases. Blood tests show an increase in hematocrit, azotemia.

Correction of hypovolemia is the responsibility of the resuscitator. In case of trauma, the surgeon is obliged to relieve the pain syndrome (high-quality immobilization, blockades).

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