Hypovolemic Shock

Piras, Cláudio

doi:10.15406/ipmrj.2017.02.00053

IPMRJ

2017

DOI: 10.15406/ipmrj.2017.02.00053

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Hypovolemic Shock

Cláudio Piras¹

Abstract: Hypovolemic shock is a complex condition very prevalent in our time. It is associated with high mortality and a prompt intervention could save lifes. Mortality is related to severity of trauma and bleed lost, management quality and time from trauma to therapy. In this review from the last 10 years of literature some aspects of pathophysiology, monitoring and treatment will be presented.

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Cited by 2 publications

References 33 publications

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Role of lung ultrasound in assessment of endpoint of fluid therapy in patients with hypovolemic shock

S.abd-alazeem

Elgazzar²,

Hammad

et al. 2021

Egyptian Journal of Anaesthesia

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Background: Different techniques are employed to assess the endpoint of fluid therapy in hypovolemic patients. Lung ultrasound (US) is increasingly becoming a diagnostic tool in the critical care setting, providing standardized data. The present study aimed to evaluate the role of lung US in comparison to central venous pressure (CVP) in assessment of endpoint of fluid therapy in patients with hypovolemic shock. Patients and methods: Observational cross-sectional study carried in 60 adult patients with hypovolemic shock admitted to the intensive care unit received lactated Ringer's solution. CVP, blood pressure (BP), urine output (UOP), and lung US score were recorded on admission and during the period of resuscitation. Lung US score was correlated with CVP, BP, and UOP and evaluated in assessment of endpoint fluid therapy in comparison to CVP as a gold standard. Results: There was a significant increase in CVP, BP, UOP,and lung US score during fluid resuscitation. Lung US showed a significant positive correlation with CVP, BP, and UOP at different stages of fluid resuscitation. Lung US score showed a sensitivity of 95.7%, specificity of 92.9% with a positive predictive value of 97.8% negative predictive value of 86.7%, and the total accuracy was 95%. Conclusion:Lung US provides a simple noninvasive approach in assessment of endpoint (score ≥16) of fluid therapy in patients with hypovolemic shock with high sensitivity and specificity.

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Role of lung ultrasound in assessment of endpoint of fluid therapy in patients with hypovolemic shock

S.abd-alazeem

Elgazzar²,

Hammad

et al. 2021

Egyptian Journal of Anaesthesia

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Emergency transfusion of different rhesus blood type: Will there be complications?

Hardy Wu,

Fitriati,

Edralyn

et al. 2024

J Emerg Pract Trauma

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Objective: Antepartum hemorrhage (APH) is one of the leading causes of maternal and fetal mortality worldwide, complicating 2–4% of pregnancies. Considering the probability of blood transfusion, blood testing and cross-matching are essential for the anesthesiologist during perioperative management. Rhesus (Rh) is the second most significant blood group system after ABO. Hence, this blood type system needs to be taken into consideration. Furthermore, in Indonesia, Rh-negative blood types are rare. Case Presentation: A 39-year-old woman with Gravida IV, three term pregnancies, no preterm pregnancies, no abortions, and three living children (GIVP3003) and gestational age 26 to 27 weeks arrived at the hospital with massive bleeding from the birth canal three hours before admission. The bleeding was fresh red, and the patient had changed diapers twice before arriving at the hospital. She presented hypovolemic shock, a blood pressure of 71/39 mm Hg, and anemic conjunctivas, with a history of B Rh (-) blood type, ongoing HIV therapy, and completed pulmonary tuberculosis (TB) treatment. The hospital’s and PMI’s (Indonesian Red Cross) blood bank had no Rh (-) bloodstock. An emergency cesarean section under general anesthesia was performed, and a 900 g neonate was delivered. The patient received a total of four stored whole blood (SWB) bags of type B Rh (+) blood products, one SWB bag during surgery, and three SWB bags during recovery in the intensive care unit (ICU). Conclusion: Rh (+) transfusion in patients with Rh (-) should be the last option in an emergency. The transfusion reaction did not occur right away in the initial transfusion. Under prompt management, the transfusion response and the life-threatening condition were then successfully managed.

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Hypovolemic Shock

Cited by 2 publications

References 33 publications

Role of lung ultrasound in assessment of endpoint of fluid therapy in patients with hypovolemic shock

Role of lung ultrasound in assessment of endpoint of fluid therapy in patients with hypovolemic shock

Emergency transfusion of different rhesus blood type: Will there be complications?

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