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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]
Renal causes include overuse of diuretics, or trauma or disease of the kidney. Extrarenal causes include bleeding, burns, and any causes of edema (e.g. congestive heart failure, liver failure). [citation needed] Intravascular volume depletion is divided into three types based on the blood sodium level:
Crystalloid fluid resuscitation is preferred over colloid solutions for severe volume depletion not due to bleeding. The type of crystalloid used to resuscitate the patient can be individualized based on the patients' chemistries, estimated volume of resuscitation, acid/base status, and physician or institutional preferences.
High volume hyponatremia can occur from heart failure, liver failure, and kidney failure. [4] Conditions that can lead to falsely low sodium measurements include high blood protein levels such as in multiple myeloma, high blood fat levels, and high blood sugar. [5] [6] Treatment is based on the underlying cause. [4]
Septic shock, especially septic shock where treatment is delayed or the antimicrobial drugs are ineffective, however has a mortality rate between 30% and 80%; cardiogenic shock has a mortality rate of up to 70% to 90%, though quick treatment with vasopressors and inotropic drugs, cardiac surgery, and the use of assistive devices can lower the ...
Diagnosis of contraction alkalosis is made by correlating laboratory data with clinical history and examination. Metabolic alkalosis in the presence of decreased effective circulatory volume, loop diuretic use, or other causes of intravascular depletion such as profound diarrhea should raise suspicion for contraction alkalosis as a likely etiology in the absence of other causes.
ECF volume contraction or hypovolemia is usually the type of volume contraction of primary concern in emergency, since ECF is approximately half the volume of ICF and is the first to be affected in e.g. bleeding. [citation needed] Volume contraction is sometimes even used synonymously with hypovolemia. [citation needed]
Hypoosmolar hyponatremia is a condition where hyponatremia is associated with a low plasma osmolality. [1] The term "hypotonic hyponatremia" is also sometimes used.[2]When the plasma osmolarity is low, the extracellular fluid volume status may be in one of three states: low volume, normal volume, or high volume.