Hypovolemia is a pathological condition manifested by a decrease in circulating blood volume, in some cases accompanied by a violation of the ratio between plasma and formed elements (erythrocytes, platelets, leukocytes).
For information, normally in adult women the total blood volume is 58–64 ml per 1 kg of body weight, in men – 65–75 ml/kg.
With hypovolemia, circulating blood volume decreases
Content:
- Causes and mechanism of development
- Classification
- Signs of hypovolemic disorder
- Treatment of hypovolemia
Hypovolemia is a decrease in blood volume with the development of alcohol withdrawal syndrome. This process occurs due to the recombination of fluid, due to its transition from the venous bed into the cells and the space between them. This phenomenon occurs during the accumulation of toxic substances inside tissues due to dysfunction of the enzyme system, coronary artery disease, and poor functioning of organs. In addition to perfusion problems, a decrease in circulating blood volume (CBV) is manifested by an inadequate ratio of systolic and diastolic blood pressure and a drop in cardiac output. Developing acute pathology is life-threatening and requires immediate medical attention.
What do lungs look like on an X-ray when infected with coronavirus?
The new virus has devastating effects on the lungs. The picture shows the respiratory system of a 44-year-old man who died from COVID-19. It is clearly visible how the disease progresses.
Along the periphery, an increase in the number of subpleural compactions of the “frosted glass” type can be seen; the lung tissue is filled with fluid more and more, ceasing to perform its functions.
Below is a photo of the lungs of a 54-year-old woman who contracted a coronavirus infection, which led to severe pneumonia. The patient required connection to an artificial lung ventilation device (ALV), and she could not breathe on her own.
The picture shows a similar picture:
- bilateral lung damage;
- increasing damage closer to the chest;
- pronounced “ground glass” syndrome;
- accumulation of a large amount of fluid that interferes with breathing.
X-rays of persons suspected of being infected with the COVID-19 coronavirus allow the disease to be identified more quickly and treatment to begin on time. This approach significantly increases the chances of recovery.
Reasons and mechanism of formation
The pathological hypovolemic process is based on severe dehydration.
Leads to it:
- Vomiting, characteristic of withdrawal syndrome after binge drinking.
- Diarrhea, with the help of which the body cleanses itself of alcohol toxins.
- Liver diseases characteristic of alcoholism (toxic hepatitis and cirrhosis). In this case, non-functional leakage of plasma into the intercellular space occurs due to a decrease in the oncotic pressure of the blood.
- Insufficient intake of fluid and protein into the body.
Hypovolemia is preceded by increased venous and hydrostatic pressure in small arteries, reflecting the negative influence of factors predisposing to a painful condition. Secondarily, the permeability of the vascular wall increases. Sweating of blood through arteries and veins leads to its general deficiency.
The body tries to compensate by:
- Producing the required amount of plasma.
- Slowing venous return.
- Spasms of small vessels.
The protective reaction allows you to maintain the activity of the brain and heart in a relatively normal state for some time and avoid circulatory complications.
Forecasts
Foggy. With proper help, or if the pathological process proceeds relatively easily - positive. But decompensation can occur at any time.
The prospects for severe injuries are much worse. Although here everything is ambiguous and depends on the moment of the start of therapy.
Hypovolemia is a syndrome inherent in many dangerous conditions. It is not him who needs to be treated. The main forces should be directed to the fight against the original source. And this must be done as quickly as possible. In this case, there is every chance of recovery without consequences.
Adelina Pavlova
Classification
The types of hypovolemia that doctors of different specializations have to deal with have several options. They are due to the dependence of the ratio of plasma and blood elements (hematocrit).
On this basis, the following types of violations are distinguished:
- Normocythemic. The volume is reduced with a normal hematocrit number.
- Oligocythemic. The amount of plasma is not changed, and blood cells are small.
- Polycythemic. BCC is low, and hematocrit, on the contrary, is high.
Narcologists most often encounter the polycythemic variant. This is what characterizes intoxication with severe vomiting and diarrhea.
To prescribe therapy, the doctor also needs to find out whether the patient has absolute or relative hypovolemia. Therefore, when making a diagnosis, the doctor examines the patient very carefully, analyzes data from laboratory tests and other special diagnostic methods. This information is required to adjust therapy.
Absolute hypovolemia occurs against the background of blood deficiency in the vascular bed. It develops due to loss of plasma and lack of fluid intake into the body. In this case, the urinary system works normally.
Relative hypovolemia is characterized by sweating of the liquid part into the intervascular space of the body. Against this background, the BCC remains normal, or even higher than normal values. This condition is also a manifestation of toxic syndrome in alcoholism.
Diagnostics
The diagnosis and degree of hypovolemia is made based on clinical symptoms.
Normally, in adult women, the total blood volume is 58–64 ml per 1 kg of body weight, in men – 65–75 ml/kg.
The scope of laboratory and instrumental studies depends on the nature of the pathology that led to a decrease in the volume of circulating blood. Mandatory minimum includes:
- determination of hematocrit;
- general blood analysis;
- blood biochemistry;
- general urine analysis;
- determination of blood group and Rh factor.
To diagnose hypovolemia, hematocrit is determined and other laboratory and instrumental studies are performed.
If hypovolemia caused by bleeding into the abdominal cavity is suspected, diagnostic laparoscopy is performed.
Signs of hypovolemic disorder
Symptoms of the disorder depend on its severity.
In the practice of narcology, the following stages of hypovolemia are distinguished:
- Easy. Minor fluid losses (up to 20% of bcc) are accompanied by a decrease in blood pressure, increased heart rate 10-15 beats higher than normal, and slight shortness of breath. The patient is pale, complains of weakness, dry mucous membranes, dizziness, and attacks of nausea.
- Average. The patient loses up to 40% of his total blood volume. In this case, the pressure is sharply reduced (below 90 mm Hg) and the pulse is above 120-130 beats per minute. Breathing is sharply rapid and intermittent. Externally, pallor and cyanosis of the skin in the area of the nasolabial triangle are revealed. There is severe sweating, lethargy, and decreased urine output due to severe thirst.
- Heavy. With a large-scale decrease in blood volume (above 40%), a critical drop in blood pressure is detected. The pulse is barely detectable and reaches 150 or more beats per minute. No urine is released. The patient's appearance indicates that he is in critical condition. There is deathly pale skin, a pointed face, sunken cheeks, and an unconscious state.
Loss of BCC is often accompanied by:
- Hypoglycemia is a serious complication of alcohol withdrawal syndrome. A harbinger of the development of hypoglycemia is any kind of liver disease, a decrease in glycogen reserves, and poor non-caloric nutrition.
- Hyponatremia is a disorder most often found in patients who abuse low-alcohol drinks (cocktails, beer). In this condition, peripheral edema occurs in combination with hypovolemia.
- Hypernatremia is a condition that occurs with encephalopathy, acute liver failure, and a clear deficiency in the amount of circulating blood.
- Hypomagnesemia is a deficiency of magnesium inside cells in people with alcoholism, regardless of its content in the plasma. The most common symptoms: general weakness of the body and drowsiness. The risk of seizures and heart problems (palpitations) may increase.
- Hypokalemia. In people suffering from alcoholism, as a rule, potassium deficiency is detected in the body, even if its content in the blood plasma is at normal levels. In combination with an overexcited nervous system, the lack of this element leads to irreparable disturbances in the functioning of the heart with a threat to life. Anyone suffering from alcohol withdrawal syndrome is prescribed potassium supplements.
This pathology manifests itself:
- Fatigue quickly.
- Depression.
- Attacks of tachycardia.
- Muscle weakness.
Alcohol withdrawal syndrome may be accompanied by metabolic acidosis, which occurs due to the accumulation in the body of breakdown products of alcohol and other substances of pathological metabolism, in the process of tissue hypoxia and respiratory alkalosis.
What does hypovolumia mean?
Hypovolumia is a term used in ultrasound examinations. It means a reduction in organ volume due to congenital anomalies, underdevelopment, or formed after certain diseases. Hypovolumia of the thyroid gland is caused by the following pathologies:
- Hypoplasia of the thyroid gland. The organ is not fully formed, often in the womb. When the amount of hormones produced by the thyroid gland is sufficient, a small size is considered normal. However, most often, due to underdevelopment of the gland, a lack of thyroid hormones occurs, which causes chronic hypothyroidism.
- Atrophy of the thyroid gland due to the death of part of the follicular tissue. In most cases it causes hormone deficiency.
Hypovolumia has 2 degrees:
- At grade 1, the required level of glandular tissue is compensated by the body. As a result, the thyroid gland continues to function normally for some time.
- Stage 2 hypovolemia of the thyroid gland is characterized by a very low level of hormones, as a result of which serious disturbances occur in the body.
The older a person is, the smaller the volume of the thyroid gland. A gradual decrease in its size is a physiological phenomenon. This condition has nothing to do with hypovolumia.
Sometimes a similar diagnosis is made - hypovolemia. This is another problem, namely a decrease in blood supply to the organ.
Treatment of hypovolemia
The main task of the doctor in treating this pathology is to eliminate the deficit in blood volume.
Additionally required:
- Strengthen the work of the heart.
- Improve oxygen supply to tissues.
- Remove toxins.
- Carry out symptomatic pharmacotherapy for acute disorders.
To achieve these goals, infusion-drip therapy is used.
Depending on the stage of the process, droppers are prescribed containing:
- Crystalloids, isotonic solution and 5% glucose.
- Reamberin, Reosorbilact.
- Dextran solution, Ringer.
- Plasma substitutes.
Cardiac and respiratory stimulants, hepatoprotectors, nootropics, and metabolic agents are added to the droppers.
In particularly severe cases, red blood cells are used and a blood transfusion is performed.
To prevent the development of hypovolemia in alcoholism, timely treatment of this pathology in a drug treatment clinic, psychotherapy, coding and rehabilitation is required.
Hypervolemia
A B C D E F G H I K L M N O P R S T U V
Hypervolemia is a condition characterized by an increase in total blood volume and usually a change in Ht. There are normocythemic, oligocythemic and polycythemic hypervolemia.
Normocythemic hypervolemia (simple) is a condition manifested by an equivalent increase in the volume of formed elements and the liquid part of the bcc. Ht remains within normal limits.
The main causes of simple hypervolemia: transfusion of a large volume of blood, acute hypoxic conditions accompanied by the release of blood from its depot, as well as significant physical activity leading to hypoxia.
Literature:
- Prehospital correction of hypovolemia / O. A. Tsarev; State budgetary educational institution of higher education prof. education "Saratov State. Medical University named after V. I. Razumovsky" Ministry of Health of the Russian Federation. — Saratov: Saratov State Publishing House. Medical University, 2015. - 141 p.
- From symptom to diagnosis: a guide for doctors / Scott Stern, Adam Saifu, Dayne Altcorn. - Moscow: GEOTAR-Media, 2008. - 810 p.
The text was checked by expert doctors: Head of the socio-psychological service of the Alkoklinik MC, psychologist Yu.P. Baranova, L.A. Serova, a psychiatrist-narcologist.
CAN'T FIND THE ANSWER?
Consult a specialist
Or call: +7 (495) 798-30-80
Call! We work around the clock!
Hypervolemia
Found (64 posts)
pediatric cardiologist August 23, 2012 / Lyudmila / Kaliningrad
In a one-year-old child, an ECG showed: hypervolemia
pulmonary artery. How serious is this? What treatment is required. Can a child outgrow this illness? open
cardiologist April 6, 2012 / Maria / 0
… . mitral valve prolapse grade 1-2 with mitral valve insufficiency grade 1. Coarthation of the aorta in a typical place. Main: CHF 2A ( hypervolemia
in the lungs) FC 3. They said that the disability group was assigned. Please tell me if the holter is normal, then the group is not... open
neurologist February 12, 2012 / Yulia / Lugansk
... arteries. Left: blood supply increased by 46%, moderate hypervolemia
;
the tone of large and medium arteries is increased; small tone... Right: blood supply increased by 45%, moderate hypervolemia
; the tone of large and medium arteries is increased; mucus tone ... open
neurologist January 25, 2012 / Lydia / Krasnoyarsk region
Hello, Doctor! I am diagnosed with hypervolemia
When I asked what it was, the doctor told me it was a vascular disease and did not prescribe any treatment. I have a strong impulsive noise on the right side of my head, roaring, it is impossible to sleep, at times ... open
psychiatrist December 29, 2011 / Lina / Krivoy Rog
... increased by 17%, mild hypertonicity, venular tone is normal. Venous outflow is impaired. Right: blood supply increased by 7%, mild hypervolemia
, the tone of large and medium arteries is normal, the tone of small arteries and arterioles is normal, the tone of venules is normal. Venous outflow ... open
neurologist December 29, 2011 / Lina / Krivoy Rog
... increased by 17%, mild hypertonicity, venular tone is normal. Venous outflow is impaired. Right: blood supply increased by 7%, mild hypervolemia
, the tone of large and medium arteries is normal, the tone of small arteries and arterioles is normal, the tone of venules is normal. Venous outflow ... open
neurologist December 17, 2011 / Larisa / Krivoy Rog
... outflow is disrupted. Right: blood flow increased by 2%, mild hypervolemia
;
the tone of large and medium arteries is normal; small tone... Left: blood supply increased by 34%; moderate hypervolemia
; the tone of large and medium arteries is normal; small tone... open
endocrinologist December 17, 2011 / Larisa / Krivoy Rog
... outflow is disrupted. Right: blood flow increased by 2%, mild hypervolemia
;
the tone of large and medium arteries is normal; small tone... Left: blood supply increased by 34%; moderate hypervolemia
; the tone of large and medium arteries is normal; small tone... open
therapist December 13, 2011 / Larisa / Krivoy Rog
... outflow is disrupted. Right: blood flow increased by 2%, mild hypervolemia
;
the tone of large and medium arteries is normal; small tone... Left: blood supply increased by 34%; moderate hypervolemia
; the tone of large and medium arteries is normal; small tone... open
neurologist December 13, 2011 / Larisa / Krivoy Rog
... outflow is disrupted. Right: blood flow increased by 2%, mild hypervolemia
;
the tone of large and medium arteries is normal; small tone... Left: blood supply increased by 34%; moderate hypervolemia
; the tone of large and medium arteries is normal; small tone... open
Which doctors should you contact if you have Hypervolemia:
Anesthesiologist
Is something bothering you? Do you want to know more detailed information about Hypervolemia, its causes, symptoms, methods of treatment and prevention, the course of the disease and diet after it? Or do you need an inspection? You can make an appointment with a doctor - the Eurolab clinic is always at your service! The best doctors will examine you, study external signs and help you identify the disease by symptoms, advise you and provide the necessary assistance and make a diagnosis. You can also call a doctor at home. The Eurolab clinic is open for you around the clock.
How to contact the clinic: Phone number of our clinic in Kyiv: (+38 (multi-channel). The clinic secretary will select a convenient day and time for you to visit the doctor. Our coordinates and directions are listed here. Look in more detail about all the clinic’s services on its personal page.
Intravenous infusions
When dehydration occurs or oral flooding is not possible, intravenous infusions are life-saving. Typically, intravenous solutions contain sodium and water to maintain fluid and electrolyte balance. But too much IV solution can lead to hypervolemia, especially with other concomitant diseases. One study showed that large amounts of intravenous fluid given to patients after surgery causes hypervolemia and an increased risk of postoperative mortality. The study examined data from patients undergoing surgery for esophageal cancer.
