Table of ContentsView AllTable of ContentsHow Hypovolemia OccursSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
How Hypovolemia Occurs
Symptoms
Causes
Diagnosis
Treatment
Hypovolemiais the loss of 15% or more of the fluid circulating in the body, specifically blood or water. Because your organs need these fluids to function, their depletion can cause organs to malfunction and fail. Symptoms include dizziness, rapid heartbeat, clammy skin, confusion, and fainting.
There are many possible causes for hypovolemia from extremedehydrationor massive bleeding. In severe cases, hypovolemia can lead to shock and death.
This article describes the symptoms and causes of hypovolemia. It also explains how this potentially serious condition is diagnosed and treated.
DefinitionHypovolemia should not be confused withdehydration. Hypovolemia is the decreased volume of fluid in the vascular system (blood vessels andlymphatic vessels) with or without whole-body fluid depletion. Dehydration is the depletion of whole-body fluid.Hypovolemia can occur as a result of dehydration but can also occur independently of it.
Definition
Hypovolemia should not be confused withdehydration. Hypovolemia is the decreased volume of fluid in the vascular system (blood vessels andlymphatic vessels) with or without whole-body fluid depletion. Dehydration is the depletion of whole-body fluid.Hypovolemia can occur as a result of dehydration but can also occur independently of it.
Hypovolemia should not be confused withdehydration. Hypovolemia is the decreased volume of fluid in the vascular system (blood vessels andlymphatic vessels) with or without whole-body fluid depletion. Dehydration is the depletion of whole-body fluid.
Hypovolemia can occur as a result of dehydration but can also occur independently of it.
skynesher / Getty Images
Hypovolemia literally means low (hypo-) volume (-volemia). It involves a decrease in the volume of extracellular fluids. Extracellular fluids are those that exist outside of cells, such as the fluid part of blood (known asplasma) or the fluid circulating in lymphatic vessels (known aslymph).
When hypovolemia becomes severe, the low volume of blood in arteries and veins will cause yourblood pressure to drop. When it drops to where organs are unable to function, the body goes intoshock.
Understanding Cells, Tissues, and Organs
What Are the Symptoms of Hypovolemia?
Hypovolemia symptoms may not be recognized in the early stages and may only become apparent when the volume depletion approaches 30%.
Hypovolemia is categorized into stages 1 through 4, which denote the percentage of fluid volumes lost. Symptoms develop in a characteristic pattern from stage to stage, as follows:
Hypovolemic Shock
In medical terms, shock is the body’s response to a sudden drop in blood pressure.
Hypovolemic shock is a medical emergency that develops in a progressive pattern. It technically starts with stage 1 hypovolemia and progresses to stage 4, at which point the insufficient flow of blood can start to damage the heart, lungs, liver, kidneys, and other vital organs.
If left untreated, multiple organ failure can occur. If treatment is not delivered quickly, the risk of irreversible damage and death is high.
Risk of DeathAccording to a 2022 study inJAMA Network Open,roughly one in three people who experience shock outside of a hospital die within 30 days, even with medical treatment.
Risk of Death
According to a 2022 study inJAMA Network Open,roughly one in three people who experience shock outside of a hospital die within 30 days, even with medical treatment.
What Causes Hypovolemia?
Hypovolemia can range from mild to severe depending on the underlying cause. Common causes include:
How Is Hypovolemia Diagnosed?
The diagnosis of hypovolemia starts with a review of your symptoms and medical history. A physical exam would then be performed and would involve the following baseline evaluations:
Other lab and imaging tests can help confirm the diagnosis, including:
How Is Hypovolemia Treated?
The standard of care isintravenous (IV) fluid resuscitationwhich involves the delivery of fluids through a vein. Crystalloid solutions comprised of water and water-soluble electrolytes like sodium and chloride are the preferred choice.Lactated Ringer’s solutionis one form of this.
Colloid solutions made up of synthetic compounds can also be used and have the advantage of quickly restoring blood pressure. But studies suggest that colloid solutions pose significant health risks, including a one-in-500 risk of a potentially life-threatening, whole-body allergy calledanaphylaxis.
If blood loss is the cause of hypovolemia, ablood transfusionwould be needed.
How Hypovolemic Shock Is Treated
Treatment is delivered in anintensive care unit. If an accident caused blood loss, you may need surgery to repair the injury.
What Are the Signs of Shock?
Summary
Hypovolemia is the loss of 15% or more of circulating fluids in the body. Causes include severe dehydration, internal or external blood loss, and severe illnesses that cause fluids to accumulate in the body cavities. Symptoms can progress from fatigue, clammy skin, and dizziness to rapid heartbeats, changes in consciousness, and fainting.
Depending on the cause, hypovolemia may be treated with intravenous or oral fluids or with a blood transfusion. Severe cases can lead to a medical emergency known as hypovolemic shock.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Djupedal H, Nøstdahl T, Hisdal J, Landsverk SA, Høiseth LØ.Effects of experimental hypovolemia and pain on pre-ejection period and pulse transit time in healthy volunteers.Physiol Rep. 2022 Jun;10(12):e15355. doi:10.14814/phy2.15355.Van der Mullen J, Wise R, Vermeulen G, Moonen PJ, Malbrain MLNG.Assessment of hypovolaemia in the critically ill.Anaesthesiol Intensive Ther.2018;50(2):141-149. doi:10.5603/AIT.a2017.0077Mandal M.Ideal resuscitation fluid in hypovolemia: The quest is on and miles to go!Int J Crit Illn Inj Sci. 2016 Apr-Jun;6(2):54-5. doi:10.4103/2229-5151.183020.Bloom JE, Andrew E, Dawson LP, et al.Incidence and outcomes of nontraumatic shock in adults using emergency medical services in Victoria, Australia.JAMA Netw Open.2022 Jan;5(1):e2145179. doi:10.1001/jamanetworkopen.2021.45179Beneš J.Diagnosing hypovolemia and hypervolemia: from clinical examination to modern methods.Vnitr Lek.2019 Spring;65(3):170-6.Sadowsky D, Suarez-Mazon A, Lugo C, Rashid T, Wu J, Gerard P, Mozzor M.Rapid Nuclear Medicine Blood Volume Analysis for Emergency Assessment. J Emerg Trauma Shock. 2020 Oct-Dec;13(4):301-305. doi: 10.4103/JETS.JETS_167_19Hahn RG.Adverse effects of crystalloid and colloid fluids. doi:10.5603/AIT.a2017.0045Anaesthesiol Intensive Ther.2017;49(4):303-8. doi:10.5603/AIT.a2017.0045Lee JJ, Kilonzo K, Nistico A, Yeates K.Management of hyponatremia.CMAJ. 2014;186(8):E281-6. doi:10.1503/cmaj.120887Kalkwarf KJ, Cotton BA.Resuscitation for hypovolemic shock.Surg Clin North Am.2017 Dec;97(6):1307-21. doi:10.1016/j.suc.2017.07.011
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Djupedal H, Nøstdahl T, Hisdal J, Landsverk SA, Høiseth LØ.Effects of experimental hypovolemia and pain on pre-ejection period and pulse transit time in healthy volunteers.Physiol Rep. 2022 Jun;10(12):e15355. doi:10.14814/phy2.15355.Van der Mullen J, Wise R, Vermeulen G, Moonen PJ, Malbrain MLNG.Assessment of hypovolaemia in the critically ill.Anaesthesiol Intensive Ther.2018;50(2):141-149. doi:10.5603/AIT.a2017.0077Mandal M.Ideal resuscitation fluid in hypovolemia: The quest is on and miles to go!Int J Crit Illn Inj Sci. 2016 Apr-Jun;6(2):54-5. doi:10.4103/2229-5151.183020.Bloom JE, Andrew E, Dawson LP, et al.Incidence and outcomes of nontraumatic shock in adults using emergency medical services in Victoria, Australia.JAMA Netw Open.2022 Jan;5(1):e2145179. doi:10.1001/jamanetworkopen.2021.45179Beneš J.Diagnosing hypovolemia and hypervolemia: from clinical examination to modern methods.Vnitr Lek.2019 Spring;65(3):170-6.Sadowsky D, Suarez-Mazon A, Lugo C, Rashid T, Wu J, Gerard P, Mozzor M.Rapid Nuclear Medicine Blood Volume Analysis for Emergency Assessment. J Emerg Trauma Shock. 2020 Oct-Dec;13(4):301-305. doi: 10.4103/JETS.JETS_167_19Hahn RG.Adverse effects of crystalloid and colloid fluids. doi:10.5603/AIT.a2017.0045Anaesthesiol Intensive Ther.2017;49(4):303-8. doi:10.5603/AIT.a2017.0045Lee JJ, Kilonzo K, Nistico A, Yeates K.Management of hyponatremia.CMAJ. 2014;186(8):E281-6. doi:10.1503/cmaj.120887Kalkwarf KJ, Cotton BA.Resuscitation for hypovolemic shock.Surg Clin North Am.2017 Dec;97(6):1307-21. doi:10.1016/j.suc.2017.07.011
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Djupedal H, Nøstdahl T, Hisdal J, Landsverk SA, Høiseth LØ.Effects of experimental hypovolemia and pain on pre-ejection period and pulse transit time in healthy volunteers.Physiol Rep. 2022 Jun;10(12):e15355. doi:10.14814/phy2.15355.Van der Mullen J, Wise R, Vermeulen G, Moonen PJ, Malbrain MLNG.Assessment of hypovolaemia in the critically ill.Anaesthesiol Intensive Ther.2018;50(2):141-149. doi:10.5603/AIT.a2017.0077Mandal M.Ideal resuscitation fluid in hypovolemia: The quest is on and miles to go!Int J Crit Illn Inj Sci. 2016 Apr-Jun;6(2):54-5. doi:10.4103/2229-5151.183020.Bloom JE, Andrew E, Dawson LP, et al.Incidence and outcomes of nontraumatic shock in adults using emergency medical services in Victoria, Australia.JAMA Netw Open.2022 Jan;5(1):e2145179. doi:10.1001/jamanetworkopen.2021.45179Beneš J.Diagnosing hypovolemia and hypervolemia: from clinical examination to modern methods.Vnitr Lek.2019 Spring;65(3):170-6.Sadowsky D, Suarez-Mazon A, Lugo C, Rashid T, Wu J, Gerard P, Mozzor M.Rapid Nuclear Medicine Blood Volume Analysis for Emergency Assessment. J Emerg Trauma Shock. 2020 Oct-Dec;13(4):301-305. doi: 10.4103/JETS.JETS_167_19Hahn RG.Adverse effects of crystalloid and colloid fluids. doi:10.5603/AIT.a2017.0045Anaesthesiol Intensive Ther.2017;49(4):303-8. doi:10.5603/AIT.a2017.0045Lee JJ, Kilonzo K, Nistico A, Yeates K.Management of hyponatremia.CMAJ. 2014;186(8):E281-6. doi:10.1503/cmaj.120887Kalkwarf KJ, Cotton BA.Resuscitation for hypovolemic shock.Surg Clin North Am.2017 Dec;97(6):1307-21. doi:10.1016/j.suc.2017.07.011
Djupedal H, Nøstdahl T, Hisdal J, Landsverk SA, Høiseth LØ.Effects of experimental hypovolemia and pain on pre-ejection period and pulse transit time in healthy volunteers.Physiol Rep. 2022 Jun;10(12):e15355. doi:10.14814/phy2.15355.
Van der Mullen J, Wise R, Vermeulen G, Moonen PJ, Malbrain MLNG.Assessment of hypovolaemia in the critically ill.Anaesthesiol Intensive Ther.2018;50(2):141-149. doi:10.5603/AIT.a2017.0077
Mandal M.Ideal resuscitation fluid in hypovolemia: The quest is on and miles to go!Int J Crit Illn Inj Sci. 2016 Apr-Jun;6(2):54-5. doi:10.4103/2229-5151.183020.
Bloom JE, Andrew E, Dawson LP, et al.Incidence and outcomes of nontraumatic shock in adults using emergency medical services in Victoria, Australia.JAMA Netw Open.2022 Jan;5(1):e2145179. doi:10.1001/jamanetworkopen.2021.45179
Beneš J.Diagnosing hypovolemia and hypervolemia: from clinical examination to modern methods.Vnitr Lek.2019 Spring;65(3):170-6.
Sadowsky D, Suarez-Mazon A, Lugo C, Rashid T, Wu J, Gerard P, Mozzor M.Rapid Nuclear Medicine Blood Volume Analysis for Emergency Assessment. J Emerg Trauma Shock. 2020 Oct-Dec;13(4):301-305. doi: 10.4103/JETS.JETS_167_19
Hahn RG.Adverse effects of crystalloid and colloid fluids. doi:10.5603/AIT.a2017.0045Anaesthesiol Intensive Ther.2017;49(4):303-8. doi:10.5603/AIT.a2017.0045
Lee JJ, Kilonzo K, Nistico A, Yeates K.Management of hyponatremia.CMAJ. 2014;186(8):E281-6. doi:10.1503/cmaj.120887
Kalkwarf KJ, Cotton BA.Resuscitation for hypovolemic shock.Surg Clin North Am.2017 Dec;97(6):1307-21. doi:10.1016/j.suc.2017.07.011
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