Chủ Nhật, 12 tháng 1, 2014


Hypovolemia Hypovolemia is the condition caused by loss of blood resulting in reduction in total volume of blood/fluids in the body. It can happen due to accident or any medical condition like internal bleeding. Even diarrhea can dehydrate the body causing intense loss of fluids. Taking diuretic drugs, excess of sweat and lack of adequate fluid in the body can also cause hypovolemia.

Due to loss of fluids/blood, the soft mucous membranes of the body will dry out and subsequently the skin will lose its elasticity becoming hard. The immune system of the body will act immediately for compensating the loss of fluids by increasing the heartbeat, and constricting blood vessels thus sustaining the regular blood flow to vital organs. Eventually blood pressure decreases suddenly causing collapse of heart and tissue damage. The condition of hypovolemia occurs when the body loses adequate blood (1/5) of the total volume. This condition is a medical emergency and has to be treated immediately.

Symptoms :

To begin with the mucous membranes will become dry and the urine output will reduce. The skin becomes rough and loses elasticity. The soft skin layer of the mouth and nose becomes hard and dry. If left untreated and there is continuous loss of fluids it can cause serious symptoms gradually.

Some of the serious Symptoms of hypovolemia are given below:-

Reduction in concentration and concentration level, change in color of the lips and fingernails (becoming pale blue), sharp pain in the chest, rapid heartbeat, palpitations, uncontrolled vomiting (which contributes for further loss of fluids) and internal bleeding are some of the serious symptoms of this disorder.

For severe cases, bloody discharge happens through rectum and for pregnant women there will be vaginal bleeding. Depending on the severity of the symptoms the person has to be hospitalized urgently.

Causes :

Loss of body fluids and blood can happen due to many factors. Persistent diarrhea, less intake of water/fluids, sudden sweating, and large burns caused by trauma can cause hypovolemia. Intake of diuretic medications (given for controlling blood pressure) can considerably reduce the urine output.

Accidents or any type of external injury can cause bleeding thus causing heavy loss of blood. Some of the rare conditions that cause this disorder are severe blood clotting, excess of sweating, kidney disorders, and repeated or uncontrolled vomiting and diarrhea. Pregnant women can lose heavy fluids when the placenta gets detached early. Hypovolemia is caused by certain life threatening factors like ectopic pregnancy (when the fetus develops outside the uterus), large burns, internal bleeding and serious injury.

Complications :

Hypovolemia if left untreated can cause serious consequences and may even be mortal. However not all the people having loss of fluids will have such conditions and only infants and elderly people are placed in high risk.

Tests :

The doctor will look for the above symptoms and tests are usually done in the intensive care unit along with treatment, for severe cases. For people with moderate loss of fluids/blood your doctor will look for the above symptoms after collecting the medical history.

Treatment :

Since hypovolemia causes fluid imbalance treatment will be oriented towards replacing body fluids or controlling loss of fluids. Depending on the cause the treatment is initiated. In case of injury or trauma, your doctor will take steps for preventing further loss of body fluids. If necessary he will provide artificial ventilation for the patient with symptoms of rapid breathing. Emergency treatment is to be given for heavy loss of blood or fluids caused by accidental injury. The patient will be put on intravenous fluids in the hospital. The doctor will keep his airway clear so that he can breathe comfortably. Blood transfusion will be done if the condition is unstable due to volumes of blood loss.

Medications are given by shots for managing blood pressure and for regularizing heartbeat and to strengthen heart contractions. The treatment can be given only after knowing the underlying medical issues that has caused loss of fluids. For patients with uncontrolled vomiting or diarrhea intravenous fluids are given for compensating fluid loss and for arresting vomiting or diarrhea. He would be given electrolyte solution for balancing loss of fluids.

Blood plasma transfusion, platelet transfusion and intravenous colloids that contain complex sugars are different methods of treatment for restoring blood volume. Depending on the severity of the case, red blood cell transfusion is done for some people. Medications like epinephrine, dopamine and vasopressors are given for maintaining blood pressure. In rare cases, hypovolemia can cause kidney/heart failure and brain damage due to sudden blood loss or fluid loss.

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