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Hypovolemic Shock 

Hypovolemic Shock
Chapter:
Hypovolemic Shock
Author(s):

Paul David Weyker

, Christopher Allen-John Webb

, and Tricia E. Brentjens

DOI:
10.1093/med/9780190226459.003.0097
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date: 19 September 2020

Broadly defined, hypovolemia represents inadequate circulating plasma volume leading to decreased cardiac preload and thus decreased cardiac output and blood pressure. Many classification schemes have been proposed to categorize hypovolemia based on relative levels of decreased plasma volume. Common causes of hypovolemic shock during the perioperative period include hemorrhage and diuretic use. In general, studies support a conservative hemoglobin goal of about 7 g/dL as compared with a liberal goal of 10 g/dL in hemodynamically stable patients without active cardiac ischemia or risk factors. In patients with large volume blood loss, institutionally approved massive transfusion protocols can help provide blood products quickly. The trauma literature supports a balanced massive transfusion protocol using a 1:1:1 (plasma:platelet:red blood cell) strategy of transfusion.

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