Hypovolemic shock
Contents:
Description:
The hypovolemia is shown when the volume of blood decreases because of a loss of blood or because of loss of ekstrakletochny liquid. If the main loss of blood heavy or compensatory mechanisms do not work, adequate coronary and cerebral perfusion cannot be reached, and hypovolemic shock appears.
Symptoms of Hypovolemic shock:
Data of the Anamnesis
The bleeding connected with surgery can be followed by anamnestic data on an injury and a loss of blood, damage by a burn, heavy vomiting and diarrhea, or.
Data of the General Clinical Trial
Early or compensatory shock
· The tachycardia increased by ChSS
· The normal or increased arterial pressure of blood
· The jumping-up peripheric pulse
· Hyperemic visible mucous
· The accelerated time of filling of capillaries (SNK)
· Tachypnea
· Pallor visible mucous if is followed with losses of blood; data about bleeding or traumatic damages if it is connected with an injury.
Late or dekompensatorny shock
· Tachycardia or bradycardia
· Low peripheric pulse
· Pallor of visible mucous
· The prolonged time of filling of capillaries (SNK)
· Cold extremities
· Hypothermia
· Depression or stupor
· Oliguria
· Tachypnea
· Exclusive general weakness
Reasons of Hypovolemic shock:
· A traumatic loss of blood in a perigastrium or lungs, in the place of a fracture, or because of a wound
· The heavy gastrointestinal bleeding accompanied with therapy with corticosteroids or non-steroidal anti-inflammatory drugs, the Neoplasia (tumor) or thrombocytopenia.
· Heavy эпистаксис (rhinorrhagia) for the second time because of an intranasal infection, the Neoplasia (tumor), or thrombocytopenia
· Intratorakalny or intraabdominal a hemorrhage, for the second time because of confusion of coagulation or because of intoxication rodentitsidny anticoagulants
· Liquid loss because of ekstenzivny burn damage, heavy vomiting, or diarrhea.
RISK FACTORS
· To be exposed to probability to come into contact with the environment of the increased danger of traumatism or burns
· To be exposed to probability to come into contact with antikoagulyatny rodenticides
· The parallel disease causing thrombocytopenia or a coagulopathy
· To be exposed to probability to come into contact with potentially risk situations, such as are expensive.
Treatment of Hypovolemic shock:
Urgent on character because there is a circulator collapse
· Powerful infusional therapy for increase in effective circulator volume.
· The balanced solutions of electrolytes in initial, starting frequency to 90 ml/kg for dogs and 40 ml/kg for cats are used. It is possible to use colloid solutions such as a whole blood, гидроксиэтилстарх, hydroxyethyl starch (Hetastarch), or dextrans in a combination with crystalloid solutions for maintenance of liquids within vascular space. Colloids-20 of ml/kg will allow a parallel dose decline of crystalloid liquids to 1/4-1/2 from a dosage, usual for shock; it is shown for heavy hypovolemia; it is used also for heavy loss of proteins (for example, patients with burns). 7.5% hypertonic saline solutions can be too used (5 ml/kg intravenously bolusno) for bystry recovery of volume.
· Refractory hypovolemic shock - it is possible to use positive inotropic therapy (Dobutaminum, Dobutaminum, dobutamine of 5-10 mg/kg/min.) or angiotonic therapy (a dopamine (Dopamine) of 5-20 mg/kg/min.) for a raising of system pressure of blood.
· Oxygen additive - is the most important factor; it is possible to apply an oxygen cell, a mask, or a nasal cannula.
