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Structural changes continue during adulthood as brain shrinkage commences after the age of 35, at a rate of 0.2% per year. [4] The rate of decline is accelerated when individuals reach 70 years old. [5] By the age of 90, the human brain will have experienced a 15% loss of its initial peak weight. [6]
Hypovolemic shock is caused by low blood volume (hypovolemia) and is the most common cause of shock in pediatric patients. Common causes of volume loss include diarrhea, vomiting, hemorrhage, not drinking enough, burns, osmotic diuresis (e.g., diabetic ketoacidosis), and third space losses. [4]
Maintenance of cerebral perfusion pressure using appropriate fluid management is essential in patients with brain injury. [3] Dehydration, or intravascular volume loss, and the use of hypotonic fluids, such as D5W or half normal saline, should be avoided.
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Hypovolemia, also known as volume depletion or volume contraction, is a state of abnormally low extracellular fluid in the body. [1] This may be due to either a loss of both salt and water or a decrease in blood volume. [2] [3] Hypovolemia refers to the loss of extracellular fluid and should not be confused with dehydration. [4]
Class 3: Volume loss from 30% to 40% of total blood volume, from 1500 mL to 2000 mL. A significant drop in blood pressure and changes in mental status occur. [3] Heart rate and respiratory rate are significantly elevated (more than 120 BPM). Urine output declines. Capillary refill is delayed. [3] Class 4: Volume loss over 40% of total blood volume.
Age-related decrease in gray matter volume was the largest contribution to changes in brain volume. Moreover, neuronal density appears to decrease, white matter microstructure gets altered and energy metabolism in the cerebellum gets altered. [ 16 ]
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