Common Causes Of Hypovolemic Shock

Hypovolemic shock is a life-threatening condition that requires immediate medical attention. Signs of onset shock include a rapid heart rate (tachycardia), cool skin, and extremely low blood pressure. It occurs when there is a significant reduction, usually twenty percent or more, in the amount of blood within the circulatory system. Although the body has many mechanisms to cope with a drop in blood volume, there is a point where the cardiovascular and nervous systems cannot compensate enough to maintain blood pressure. If normal blood pressure is not restored quickly, vital organs such as the brain, kidneys, and liver will fail from a lack of oxygen and nutrients. Hypovolemic shock (hypo = low and volemic = volume) is one of several types of shock caused by a disruption in the regular function of the cardiovascular system. The onset of hypovolemic shock may be gradual or rapid depending upon the cause and the patient's health status and physical size, as well as how quickly they receive medical treatment. Being aware of conditions that can lead to hypovolemic shock is the first step in saving a life.

Serious Wounds And Injuries

Blood loss, which can be internal or external and gradual or rapid, from serious wounds and injuries is one of several possible causes of hypovolemic shock. Blood loss from superficial cuts is usually gradual. Bleeding slows as the blood clots and eventually the bleeding stops. Applying pressure to the wound helps slow and stop and bleeding. Superficial wounds may still require medical attention to close the wound and prevent infection.

A deep laceration of soft tissue, or a partial or complete amputation of a body part, can cause rapid blood loss and hypovolemic shock if not treated quickly. Blunt force trauma or crushing injuries can cause bleeding externally and internally and swelling that also contributes to shock. Accident victims often have a combination of wounds and injuries with external and internal blood loss and need immediate medical treatment.

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Internal Bleeding

Internal bleeding (bleeding inside the body) reduces the amount of blood in the cardiovascular system. This drop in volume can be gradual or rapid and may lead to hypovolemic shock. Serious wounds and injuries that damage internal organs can cause significant blood loss. Trauma to the spleen frequently causes internal blood loss that is usually rapid and therefore life-threatening. The rupture of a major artery, such as an abdominal aortic aneurysm, also causes rapid blood loss and hypovolemic shock.

Other possible causes of internal blood loss are broken bones, gastrointestinal ulcers, and growths, tumor growths that rupture blood vessels, complications during pregnancy or childbirth, anticoagulation medication, inherited bleeding disorders, bleeding after surgery, and long-term, excessive alcohol consumption. Internal bleeding, whether gradual or rapid, requires prompt medical care.

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Endometriosis

The lining of the uterus is called the endometrium. Endometriosis is an abnormal condition where the endometrial cells migrate outside of the uterus into the pelvic cavity. These cells may grow and attach to organs such as the fallopian tubes or the ovaries or attach to the bowel or tissues lining the pelvis. During a woman's menstrual cycle, this misplaced tissue bleeds, just like the endometrium inside of the uterus, and this bleeding may contribute to the formation of cysts and adhesions. Complications from endometriosis that lead to hypovolemic shock are rare. In cases where it has occurred, there was a buildup of body fluids, including blood, in the pelvic cavity.

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Severe Burns

The severity of a burn is classified using a combination of variables including the age and gender of the burn patient, the size of burn area (expressed as a percentage), how much tissue suffered a full-thickness burn, and if the patient was also injured by inhaling hot air, smoke, or other gases. Immediate emergency medical care is always required, as the effect of severe burns on the body is dramatic and complex. Proteins and hormones are released rapidly from the burned tissue, contributing to an inflammatory reaction that leads to rapid edema (swelling) around the injury.

This redistribution of fluids from surrounding tissues to the burn injury upsets the normal fluid balance in the body. At the same time, the blood vessels around the burned tissue dilate, which is another factor that upsets the fluid balance. The dilation causes continual blood loss, precipitating a drop in blood volume and a reduction in cardiac output. Severe burn injuries can cause a decrease in body temperature while metabolism increases and the body requires more oxygen and other nutrients. Among other factors, fluid loss from severe burns can quickly lead to hypovolemic shock.

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Excessive Vomiting And Sweating

Excessive vomiting and sweating depletes body fluids and causes dehydration. The result is a reduction in blood volume that can lead to hypovolemic shock. If the two occur together, such as an infection that causes vomiting accompanied by a high fever causing sweating, the risk for severe dehydration is high. The risk is less if only one of these conditions is present.

In cases of excessive vomiting, the body loses not only fluids but also electrolytes important in maintaining cardiovascular function. It is often difficult to replace lost fluids and electrolytes quickly enough without medical intervention. Fluid loss from excessive sweating, if caused by working or exercising in a hot environment, can often be reversed. Even moving to a cooler location and drinking fluids with electrolytes is helpful. However, if fluid loss approaches twenty percent or more, hypovolemic shock is a possibility.