Hypovolemic shock: the need for early intervention
Rogove, H.J.
Journal of the American Osteopathic Association 82(5): 321-325
1983
ISSN/ISBN: 0098-6151 PMID: 6826387 Document Number: 197582
Hypovolemic shock is either the absolute loss of intravascular volume or the relative redistribution of volume. A diagnosis of shock can be made without all components of hypotension, oliguria, or altered mental states being present. Adjuncts to assessment and treatment include an evaluation of colloid osmotic pressure and arterial lactate levels along with the employment of a central venous pressure (CVP) line or pulmonary artery catheter. In addition to fluids, the mainstays of hypovolemic shock therapy include the pneumatic anti-shock Garment, vasopressor agents and sodium bicarbonate to correct acidemia. Corticosteroids, micropore filters and Ca replacements should be critically reviewed for their efficacy in treating hypovolemia. Resistant shock in the face of volume replacement requires a serious look at other etiologies. The endpoint for therapy should include a combination of arterial pressure restoration, urine output, acceptable CVP (or wedge pressure) measurements and improved arterial lactate levels.