What types are included in hypovolemic shock?

Generally, hypovolemic shock is a type of shock caused by a sudden decrease in effective circulating blood volume. It mainly includes hemorrhagic hypovolemic shock, hypovolemic shock due to fluid loss, traumatic hypovolemic shock, burn-induced hypovolemic shock, and endocrine-related hypovolemic shock. Detailed analysis is as follows:

1. Hemorrhagic hypovolemic shock: This is mostly caused by acute and significant blood loss, commonly seen in conditions such as massive gastrointestinal bleeding, postpartum hemorrhage, or trauma causing rupture of major blood vessels. A large loss of blood leads to a sharp reduction in circulating volume. Early signs include increased heart rate and decreased blood pressure. If bleeding is not promptly controlled, inadequate tissue perfusion rapidly develops.

2. Hypovolemic shock due to fluid loss: This results from substantial loss of body fluids, frequently occurring in cases of severe vomiting, diarrhea, excessive sweating, or diabetes insipidus. Fluid loss accompanied by electrolyte imbalances reduces effective circulating volume. Patients may present with symptoms such as thirst, dry skin, and reduced urine output.

3. Traumatic hypovolemic shock: Often caused by severe trauma, such as fractures or internal organ injuries. Blood and fluid loss may accompany the trauma, and the stress response can worsen circulatory dysfunction. Besides circulatory instability, patients may also experience pain and swelling at the injury site.

4. Burn-induced hypovolemic shock: Occurs after extensive burns. Large amounts of fluid exude from burn wounds, and increased vascular permeability leads to fluid leakage into surrounding tissues, resulting in insufficient effective circulating volume. This typically develops within hours after the burn injury, with patients showing redness, swelling, and pain at the burn site.

5. Endocrine-related hypovolemic shock: Caused by endocrine disorders that disrupt fluid regulation, most commonly seen in adrenal insufficiency. Insufficient adrenal hormone secretion weakens vasoconstriction and causes abnormal fluid distribution, leading to reduced effective circulating volume. Patients may exhibit fatigue, low blood pressure, and skin hyperpigmentation.

When signs of hypovolemic shock appear, the underlying cause must be promptly identified, effective circulating volume rapidly restored, and treatment directed at the primary condition. During treatment, vital signs, urine output, and electrolyte levels should be closely monitored. Therapeutic strategies should be adjusted according to the patient’s condition to improve tissue perfusion and reduce the risk of complications.